You finished residency. You have a signed contract that pays more than anyone in your family has ever earned. You also have six figures of student loan debt, nothing saved for a down payment, and a start date that is still weeks away.
The lender your agent recommended looked at all of that and told you the same thing everyone else did: come back when you have two pay stubs and twenty percent down.
That answer is wrong, and it is wrong for a reason worth understanding. Physician loan programs will finance up to 100% of a primary residence with no mortgage insurance at any loan-to-value, and they let a doctor qualify on a fully executed employment contract instead of pay history. In CMG Financial's MedPro Premier guidelines (NMLS #1820, revised 09/11/2026), that is 100% financing to $1,500,000 with a 680 score, or to $2,000,000 with a 720, on a one-unit primary residence.
The programs exist because the underwriting math on physicians is genuinely different, not because anyone is doing you a favor. The part that decides your file is narrower than the headline, and it is worth understanding before you fall in love with a house.
Who actually counts as a physician
The designation list is explicit, and there are no substitutions. Under the MedPro Premier guidelines, at least one qualifying borrower must hold one of: MD, DO, DDS, DMD, PharmD, DVM, VMD, DPM, or CRNA. Residents, fellows and interns holding those degrees are included. The guidelines also name Doctor of Ophthalmology, Doctor of Psychiatry, and Nurse Practitioners with an MSN or DNP.
What that list does not include matters as much as what it does. If your degree is not on it, the answer is not "close enough." It is a different program, and there is usually a good one, which is the subject of a separate post in this series on graduate and professional programs.
The two structures, and why they are not interchangeable
There are two common shapes to a physician loan, and lenders do not always explain that you are choosing between them.
The high-leverage fixed option. MedPro Premier runs fixed rate terms of 15, 20, 25 and 30 years plus hybrid ARMs, on a primary residence, for purchase or rate and term refinance. The eligibility matrix allows 95% to $2,000,000, and 100% to $1,500,000 at 680 or to $2,000,000 at 720. Mortgage insurance is not required regardless of loan-to-value. Above 90.01%, secondary financing is not allowed and escrow accounts are required unless state law prohibits them.
The adjustable option at 95%. MedPro Advantage (revised 07/16/2025) is a different animal: a fully amortizing ARM in 5/6, 7/6 and 10/6 SOFR terms, purchase of a primary residence only, 720 minimum score, 43% maximum debt-to-income, and six months of reserves. It runs $400,000 to $1,500,000 at up to 95%, and $1,500,001 to $2,000,000 at up to 90%. Mortgage insurance is again not required. Condominiums in Florida are specifically ineligible, which tells you how property-specific these programs get.
Notice what separates them. The Advantage program caps debt-to-income at 43% and demands six months of reserves. The Premier program allows more leverage and, on fixed rate terms, more room in the ratio. A resident with a new contract and thin savings and a mid-career partner with a large balance sheet are not the same file, and they should not be pushed into the same product.
The trap: 100% financing is a tool, not a default
A physician loan solves a specific problem. You have a strong forward income trajectory, limited savings early in your career, and a student loan balance that would sink a conventional debt-to-income calculation. If that is your situation, this is the structure that gets the house bought.
If it is not your situation, be careful. Putting zero down means you own no equity on day one, and in a market that moves sideways for two years you have no cushion to sell or refinance into. If you have 20% available and your ratios work, run conventional financing side by side and compare the total cost over the years you realistically hold the loan, not over thirty. Sometimes the physician program still wins on cash preservation. Sometimes it does not. The comparison is the point.
What to have ready
For a program that qualifies you on future income, the document set is smaller than you expect and more specific than you expect:
- The fully executed employment contract. Not an offer letter under negotiation. Executed, with the start date and the compensation structure.
- Proof of the designation. The degree or the license.
- Your student loan detail, including whether anything sits in deferment, forbearance or an income-based repayment plan showing zero. Residents and fellows get specific treatment there, and it is significant enough that it has its own post in this series.
- Reserves documentation, because the ARM structure in particular requires six months and that is verified, not asserted.
Where you will actually be working
Scottsdale's physician population is concentrated across three HonorHealth campuses, and where you land changes the commute and therefore the search.
HonorHealth Scottsdale Osborn Medical Center sits in south Scottsdale near Old Town, with over three hundred beds, a Level 1 trauma center and one of the largest military trauma training programmes based at a civilian hospital in the country.
HonorHealth Scottsdale Shea Medical Center is on Shea Boulevard, central to the Shea corridor and McCormick Ranch.
HonorHealth Scottsdale Thompson Peak Medical Center is a 120 bed facility north of Loop 101 and Scottsdale Road, which is the campus that pulls buyers toward Grayhawk, DC Ranch and north Scottsdale generally.
Mayo Clinic's Phoenix campus is a short run west from north Scottsdale and draws a large share of the physicians who end up buying here.
That geography matters because Scottsdale is long. South Scottsdale and north Scottsdale are a different commute, a different housing stock and a different price band, and a file built for one is not built for the other.
Where Scottsdale buyers get caught
Three things, repeatedly, and all three are local.
The price point runs into the ceiling. This is the Scottsdale problem specifically. In Mesa or Gilbert the program limits are academic. Here they are the live question. 100% financing reaches $1,500,000 at a 680 score and $2,000,000 at a 720, and north Scottsdale routinely prices past both. Above $2,000,000 the program ends and you are in true jumbo with a different set of investors, larger down payments and a longer approval. Start that conversation before the offer, not after.
Which makes the 720 threshold worth real effort here. Forty points of credit score is five hundred thousand dollars of loan amount, and rescores are expressly permitted provided the file documents the change and still meets the asset requirements.
The saved down payment disqualifies you. The program notes set a minimum loan-to-value of 90.01%. Scottsdale attracts physicians arriving with equity from a house somewhere else, and a buyer bringing twenty percent is below the floor and not eligible. That is not a disadvantage, it usually means conventional is the cheaper loan, but it needs saying before anyone runs credit.
Condos and the association stack. Scottsdale has a great deal of attached product, and two separate things bite. First, 100% financing is one unit only. Second, a luxury condominium project with substantial commercial space, high investor concentration, single-entity ownership or pending litigation can be unfinanceable on an agency basis regardless of your file. Old Town and the Scottsdale Road corridor are full of exactly the mixed-use buildings that fail warrantability, and non-warrantable programs exist for them at reduced leverage.
Association dues deserve their own line. Scottsdale HOA and club dues can be substantial, they sit inside PITIA, and they push directly against a ratio capped at 50% at 95% loan-to-value or below and 45% above it. Two identical incomes buying two identically priced homes can land on opposite sides of that ceiling on dues alone.
Acreage, if you are looking north. On ARM and 15-year fixed rate loans there is a maximum of 10 acres alongside a 45% ratio cap. Past the 101 and out toward Rio Verde, parcels that size are real, and the product choice and the lot become one decision.
Timing against a start date
Qualifying on a contract means the lender is underwriting a job you have not started. The start date must be no more than 150 days after the note date, or within 60 days of closing for a 1099 contractor position.
And closing early is not free: you must document the full housing payment for every month between the note date and your start date, rounded up, in addition to the program minimum. At Scottsdale payment sizes those months are large. A physician closing three months early at high leverage can be documenting six months of a Scottsdale housing payment, liquid, at the same moment they are paying to move across the country.
Count that in March rather than discovering it in May.
Why bring this file to us
- We read the contract, not just the paystub. A signed, fully executed employment agreement is qualifying income on these programs, and the start date drives the whole timeline.
- We tell you when the physician program is the wrong answer. At lower loan-to-value with cash in the bank, conventional financing is frequently cheaper. That comparison is the first call, not an afterthought.
- Scottsdale condo experience. Physician programs restrict condos differently than agency does, and a Florida condo exclusion on one program tells you how specific these rules get.
- Broker model. Multiple investors rather than one bank's shelf, which is what a file like this needs when the first answer is no.
- You talk to the principal. Ricky Khamis is President of EPiQ Lending, NMLS #173141, lending in Arizona since 1999. Direct line: (480) 999-9842.
EPiQ Lending is NMLS #1936984, at 7975 N. Hayden Road, Suite A-101 in Scottsdale. Verify all of it before you trust any of it: Ricky's EPiQ Lending profile, the Scottsdale branch, and the license itself at NMLS Consumer Access. Hold every lender to that standard, including us.
Send me your contract and your license, and I will tell you which of these structures your file actually fits before you start looking in Scottsdale.
Program figures in this post are from the CMG Financial (NMLS #1820) guideline set named above, as published on the revision date given. They describe one investor's program at one point in time. Other investors price and underwrite the same borrower differently, guidelines change without notice, and nothing here is an offer of any specific program or terms. Confirm current eligibility on your own file before you plan around any of it.
Equal Housing Opportunity. This is general information, not a commitment to lend or an offer to extend credit. Rates, terms, and program guidelines change and depend on credit approval, property appraisal, income and asset verification, and other qualifying factors. Not all applicants will qualify. Non-QM, asset-based and business purpose financing carry different pricing, terms and consumer protections than agency financing. Consult your tax advisor regarding the tax treatment of any income or distribution strategy.
Find out what you qualify for before you start looking
Tell me where you are in training or practice and I will tell you which structure fits your file, what it needs, and what it does not. No credit pull to have the conversation.
Looking at a specific home? Send me the address and I will run the numbers: rickykhamis.com/analyze
