Physician Mortgages for Residents

Ryan Inman Published Oct 11, 2026 Updated Oct 16, 2026 6 min read

Physician finance

Yes, residents can get physician mortgages. You do not need to be an attending. Every major physician loan program accepts residents and fellows, several let you close before your residency even starts, and the underwriting is built around exactly your situation: low current income, high student debt, high future income. The harder question is whether you should buy at all, because the math of a three to seven year horizon is unforgiving. This post covers what lenders allow, the student loan angle that makes or breaks your approval, and the honest buy or rent framework.

The short version

A resident earning the average PGY-1 stipend of $68,166 with the median $215,000 in medical school debt can qualify for a physician mortgage at 0% down, usually capped between $600,000 and $1 million depending on the lender. The student loan treatment is what makes approval possible: programs that exclude deferred loans from your debt to income calculation can take $2,000 or more per month of phantom debt off your application. Buying still only makes sense if you will stay put long enough for the equity math to work, which usually means at least five years.

The resident numbers

Start with the actual financial picture. The AAMC's 2025 Survey of Resident/Fellow Stipends and Benefits puts the average PGY-1 stipend at $68,166, covering 114,361 residents and fellows (AAMC). That is about $5,680 per month before taxes. On the debt side, the AAMC's Debt Fact Card for the class of 2025 reports median education debt of $215,000 for indebted graduates, with 70% of graduates carrying some education debt and an average balance of $223,130 (AAMC; ELFI).

A conventional underwriter looks at those two numbers and sees a problem. Fannie Mae counts 1% of the student loan balance as a monthly payment for loans in deferment or forbearance. On $215,000 in deferred loans, that is $2,150 per month of debt on a $5,680 per month income, before housing is even counted (MedMoneyGuide, citing Fannie Mae). That is how a resident with a $1,900 housing payment shows a 71% debt to income ratio on a conventional application and gets rejected for a house they can actually afford.

What lenders allow for residents

Residents and fellows are explicitly eligible at every major physician loan program, but several lenders cap trainees below the program's headline maximum:

Huntington Bank: 100% financing up to $1,000,000 for residents, the same as practicing physicians. 50% DTI ceiling (Huntington Bank).

TD Bank: 0% down to $1,000,000 for licensed medical residents and fellows. Fixed or adjustable rate. Property must be in a TD operating state (TD Bank).

BMO: 100% to $1,000,000 for residents and fellows. All states except New York (BMO).

Truist: licensed residents, interns, and fellows capped at a $1,000,000 maximum loan (Truist).

Fifth Third Bank: New Doctor program for interns, residents, and fellows. Up to $750,000 with no down payment; new physicians up to $1 million (Fifth Third Bank).

KeyBank: licensed residents and fellows capped at $750,000 with up to 100% financing, against a $3.5 million program ceiling (Student Loan Planner).

Citizens Bank: $600,000 maximum for licensed residents, fellows, and interns; $400,000 if unlicensed (Citizens Bank program document).

Bank of America: residents and fellows eligible, plus salaried medical students starting within 90 days of closing. Minimum 3% down. Requires a BofA account and 4 to 12 months of PITIA reserves (Bank of America).

Two patterns to notice. First, the resident cap clusters around $600,000 to $1 million at 0% down, which is plenty in most markets but can bind in high cost coastal cities. Second, several lenders specify licensed residents. Ask whether your training license satisfies the requirement before you apply (MedMoneyGuide).

The deferment and DTI angle

This is the mechanic that makes resident physician mortgages work. Physician programs handle student loans differently from conventional underwriting in two ways: a higher overall DTI ceiling (up to 50% versus 36 to 45% conventional), and favorable counting of the student debt itself.

Truist publishes the clearest rule: student loans may be excluded from DTI if they will be deferred for at least 12 months after closing (MedMoneyGuide, citing Truist). Fifth Third excludes loans in deferment or forbearance for at least 12 months after closing (Student Loan Planner). Bank of America can often exclude student debt with documentation that payments are deferred (MedMoneyGuide).

Run the DTI math for a resident earning $72,000 ($6,000 per month) with $285,000 in federal loans and a $1,900 housing payment (MedMoneyGuide): under Fannie Mae rules with deferred loans, the counted student loan payment is $2,850 per month, total monthly debt is $4,750, and DTI is 79%, above the maximum. At a program that excludes the deferred loans, the counted payment is $0, total debt is $1,900, and DTI is 32%. Same borrower, same house, same income. The only thing that changed is how the underwriter counts student loans.

One nuance from List with Clever worth knowing: if you are on an income driven repayment plan and your servicer will document your actual payment in writing, Fannie Mae lets a conventional lender use that documented payment instead of the 1% figure. A documented $0 IDR payment can close most of the gap between conventional and physician underwriting on the student loan line. The physician program's advantage is largest when your loans are deferred and you cannot document a $0 payment.

Should a resident buy at all

This is the question the mortgage industry will not ask you, because every lender in this post makes money when you say yes. Ask it yourself with a calculator.

The case for buying as a resident has three legs. First, you will live there three to seven years, which is long enough for the math to work in a normal market. Second, your monthly payment is at or below comparable rent, so you are building equity instead of paying a landlord. Third, you have cash reserves beyond the down payment, because at 0% down you still need closing costs, moving costs, and an emergency fund. A resident who buys with zero reserves is one roof repair away from a crisis.

The case against buying is the horizon math. At 0% down on a $600,000 home at a 7.23% physician loan rate, you pay down about $18,800 of principal in the first three years. Against that, you paid closing costs to buy and you will pay selling costs to sell. In a flat market, three years of ownership roughly breaks even against renting, before maintenance.

There is also the career risk specific to residents. Match lists change. Fellowship plans change. A house is an anchor, and anchors are expensive to move.

The resident decision framework

Buy as a resident if most of these are true:

You expect to stay at least five years, ideally through fellowship or into an attending job in the same area.
The monthly payment at 0% down is comparable to rent for an equivalent home, not double the rent.
You have cash reserves beyond closing costs: an emergency fund, moving costs, and a maintenance buffer.
Your student loans are deferred at least 12 months past closing, or you can document your IDR payment, so the DTI math works cleanly.
You have verified the resident cap and the state coverage at two to three lenders, not one.

Rent as a resident if most of these are true:

Your likely horizon is three years or less, or fellowship location is uncertain.
Buying would stretch you to the top of the resident cap with no reserves left over.
Comparable rent is meaningfully cheaper than the mortgage payment, taxes, insurance, and maintenance combined.

Closing before residency starts

Most programs let you close 60 to 90 days before your start date using a signed contract instead of pay stubs, some stretch to 120 or 150 days (Lumen Mortgage). Do not lock a rate or schedule movers until the contract is signed by both parties.

Sources

Balance and equity figures computed by standard 30 year amortization at the stated rates.

Last reviewed: October 4, 2026. Limits and program terms change; the reviewed date moves when they do.

Ryan Inman spent 10 years as a financial advisor to physicians, hosted the Financial Residency podcast, and founded Financial Fellowship to teach physicians the money mechanics of a medical career.

Have a money question from your own training or practice? Submit it at financialfellowship.com/submit. Real questions get real answers.

Have a money question we have not answered?

If you have a question about a decision you are about to make, ask it here.

Ask your question