Physician Loans in Southern California: A Plain-English Guide for Doctors
By Idrees Khan, Mortgage Loan Officer · NMLS #694081 · Pacific Lending
If you're a resident matching into a program in Loma Linda, a fellow in Orange County, or an attending who just signed with a group in Riverside, you've probably noticed something frustrating. Your future income is strong, but on paper you look like a risky borrower. You may have six figures of student debt, not much savings yet, and a work history that's mostly training.
Traditional underwriting isn't built for that profile. Physician loans are. Here's how they typically work, and how I help medical professionals across the Inland Empire and Southern California decide whether one makes sense.
What is a physician loan?
A physician loan is a mortgage program designed around the way medical careers actually unfold: years of training, heavy student debt, and then a big jump in income. These loans are typically offered as specialty programs rather than standard Fannie Mae or Freddie Mac loans. That's why they can be more flexible on down payment, mortgage insurance, and student loans.
They're usually meant for buying or refinancing your primary residence. Our medical professional loan program is available for both purchase and refinance.
Who typically qualifies?
Eligibility varies by program, but these loans commonly cover:
- Physicians (MD and DO), including attendings
- Residents and fellows still in training
- Dentists (DDS and DMD)
- In some programs, other advanced medical professionals
If you're not sure your specialty or degree qualifies, ask. Program lists differ, and I'd rather confirm your options than have you assume you're out.
The key features, and how they really work
1. Low or no down payment
The headline feature is financing up to 100% of the purchase price for qualified borrowers, which means little or no money down. That lets you keep your savings for reserves, moving costs, board exams, or simply a cushion during your first year as an attending.
Keep in mind that many physician programs set tiers: the larger the loan amount, the more down payment may be required. Requirements depend on the program, your credit, and the property.
2. No private mortgage insurance
On a typical conventional loan, putting less than 20% down means paying PMI every month until you build enough equity. Physician loans typically don't charge PMI, even with a low or zero down payment.
On a Southern California home price, that can make a real difference to your monthly payment. Just make sure you compare the whole picture: rate, fees, and terms, not only the missing PMI line.
3. Qualifying with a signed employment contract
This is the feature that surprises people most. With many physician programs, you can qualify using your signed employment contract instead of years of pay stubs and tax returns. That means no two-year employment history is needed. Many programs allow you to close up to 60–90 days before your start date, depending on the program and your file.
For comparison, standard Fannie Mae guidelines also allow qualifying on a future job offer in some cases. Those rules are narrower, though: they generally require the start date to be within 90 days after closing, and they may require extra reserves.
Why this matters for doctors relocating to Southern California: You can line up a home before you arrive, rather than renting for a year while you build a pay history.
4. Student loans handled more favorably
Student debt is the biggest reason doctors get tripped up on standard loans. On most mortgages, your student loan payment counts against your debt-to-income ratio (DTI) even if you're in deferment or paying very little.
Here's how the standard rules generally work:
- FHA: If your credit report shows a $0 payment, the lender generally must count 0.5% of your outstanding balance each month. On $300,000 of student debt, that's $1,500 a month on paper, even if you're paying nothing.
- Conventional (Fannie Mae): If you're on an income-driven plan with a documented $0 payment, a $0 payment may be used. For deferred loans or loans in forbearance, lenders may count 1% of the balance or a fully amortizing payment. On $300,000, the 1% option is $3,000 a month on paper.
Physician loan programs typically use your income-driven repayment (IDR) amount, or a more favorable calculation for deferred loans. That can significantly improve what you qualify for. Each program sets its own rules, so I'll walk you through how your specific loans would be counted.
A 2026 note on student loan repayment plans
Federal repayment has changed a lot recently. A court order ended the SAVE plan in March 2026. On July 1, 2026, the Department of Education launched the new Repayment Assistance Plan (RAP), an income-driven plan, along with a Tiered Standard plan. If you were in SAVE, your servicer has likely asked you to choose a new plan.
Your qualifying payment for a mortgage generally depends on your current, documented payment. So if you're switching plans, let's talk before you apply. That way we know which number an underwriter will see.
Physician loan vs. conventional loan
| Physician loan (typical) | Conventional loan | |
|---|---|---|
| Down payment | Little or none for qualified borrowers, depending on the program and loan amount | As low as 3% for eligible buyers; 20% to avoid PMI |
| Mortgage insurance | Typically none | PMI usually required under 20% down |
| Employment contract | Commonly accepted, with closing often allowed before your start date | Allowed in limited cases with tighter timing and reserve rules |
| Student loans | Often IDR-based or favorable calculations | Set formulas (for example, 1% of the balance for deferred loans) |
| Property use | Typically primary residence | Primary, second home, or investment |
Program guidelines vary by lender and change over time. This table is a general overview, not a commitment to lend.
Southern California home prices and loan limits
Loan size matters here. For 2026, the conforming loan limit for a single-family home is $832,750 in Riverside and San Bernardino Counties, and $1,249,125 in Los Angeles and Orange Counties. Above those amounts, a standard loan becomes a jumbo loan, which often comes with stricter down payment and reserve requirements.
Physician programs can be especially helpful in that range. Our program offers financing of $1M and up for qualified borrowers. Exact maximums and down payment requirements depend on the program and your situation.
Are there trade-offs?
Yes, and I always want you to see them clearly:
- Rates and fees may differ from a conventional loan. A no-PMI doctor loan isn't automatically the lowest-cost option. If you have 20% down, a conventional loan may come out ahead.
- Reserves may be required. Some programs want to see a certain amount of savings after closing.
- Starting with less equity means less cushion if home values shift or if you sell within a few years.
- Program terms vary, including fixed and adjustable options, so it's important to understand what you're choosing.
My job is to run the numbers both ways so you can make an informed decision.
What about doctors in private practice?
If you're a practice owner, a partner, or paid on a 1099, qualifying works differently. Our Self-Employed Homebuyer's Guide explains how self-employed income is evaluated. A physician program may still be an option, depending on your situation.
Frequently asked questions
Can residents and fellows get a physician loan?
Often, yes. Many programs include residents and fellows, and some let you qualify using your training contract or your signed attending contract. Eligibility depends on the program and your file.
Do I really not need a down payment?
Many physician programs offer up to 100% financing for qualified borrowers, but requirements can increase with the loan amount. Closing costs and reserves are separate, so plan for those too.
Will my student loans keep me from qualifying?
Not necessarily. Physician programs typically count student loans more favorably than standard formulas do, often using your income-driven repayment amount. Your documented payment and plan matter, so let's review them together.
Can I use a physician loan to refinance?
Yes. Our medical professional program is available for refinancing as well as purchases. If your main goal is a lower rate or payment, our rate and term refinance page explains that option too.
How early should I start?
Ideally, as soon as you have a signed contract, or even before you start looking at homes. Getting pre-qualified early helps you understand your budget and timeline around your start date.
Let's map out your options
Medical training asks a lot of you. Your mortgage shouldn't add to the stress. I'll review your contract, student loans, and goals, and show you how a physician loan compares with other options, in plain English and with no pressure.
Call or text me at (909) 605-3844, email ikhan@paclending.com, or start the 1-minute request on our medical professional loan page. No obligation, and no hard credit pull to get started.
This article is for educational purposes only and is not a commitment to lend, a loan approval, or financial or tax advice. Program availability, eligible professions, loan amounts, down payment and reserve requirements, and student loan treatment vary by program and borrower qualifications and are subject to change. Rates and terms are not guaranteed. Student loan details reflect federal guidance current at the time of writing; consult your servicer about your repayment plan.
Idrees Khan, NMLS #694081 · Pacific Lending, LLC, NMLS #1156766 · 3800 Concours St, Suite 160, Ontario, CA 91764 · View the states where Pacific Lending is licensed · Equal Housing Opportunity.
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