You have never missed a payment in your life. Your score is fine. You assumed that part of this was handled.
Then the pre-approval came back smaller than you expected, and nobody explained why.
On physician programs, credit score is not a sliding scale that nudges your rate. It is a set of hard thresholds that unlock loan amount and leverage, and the gap between two of them is large.
The thresholds
From CMG Financial's MedPro Premier guidelines (NMLS #1820, revised 09/11/2026), on a primary residence purchase or rate and term refinance:
- 680 score: 95% loan-to-value to $2,000,000
- 680 score: 100% loan-to-value to $1,500,000, one unit only
- 720 score: 100% loan-to-value to $2,000,000, one unit only
Read the last two together. At 680 you can borrow $1,500,000 with nothing down. At 720 you can borrow $2,000,000 with nothing down.
Forty points of score is worth five hundred thousand dollars of loan amount. If you are sitting at 705 and shopping above $1,500,000, that is the highest-return work available to you, and it usually takes weeks rather than years.
The alternative program, MedPro Advantage (revised 07/16/2025), runs an adjustable structure to 95% leverage with a 720 minimum score, a 43% maximum debt-to-income and six months of reserves. Tighter on every axis, so the score question matters there too.
Derogatory credit events
Four years of seasoning is required for derogatory credit events.
That is the rule in one line. A bankruptcy, foreclosure, short sale or deed in lieu needs four years behind it. If you are inside that window, this program is not available and the conversation should move to what is.
The inquiry rule that catches physicians
This is the one that surprises people, and physicians trip it more than most because they are furnishing a house and buying a car for a new city at exactly the wrong moment.
If the credit report indicates inquiries within the most recent 90 days, the lender must confirm you did not obtain additional credit that is not reflected in the report or the application. You will be asked to explain the reason for each inquiry.
And if you did obtain additional credit, verification of that debt must be provided and you must be qualified with the monthly payment. Confirmation of no new debt can come from a new credit report, a pre-close credit report, or a gap credit report.
So the furniture store financing you opened in week two of a 45 day escrow is not invisible. It is a new monthly payment, dropped into your ratio, at the last moment, on a program where the ratio ceiling is already the binding constraint for most attendings.
Do not open credit between application and closing. Not for furniture, not for a car, not for a practice line. It can undo the approval.
Frozen bureaus
Credit reports with bureaus identified as frozen must be unfrozen, and a current report with all bureaus unfrozen is required.
Many physicians froze their credit after a breach notice and forgot. Unfreeze all three before you apply, because discovering it mid-process costs days you may not have.
Rescores
The investor will allow credit score refreshes, but the closed loan file must include all documentation supporting the change in score, and the file must still meet the program's asset requirements.
That is a real path if you are a few points under a threshold. Paying down a revolving balance and having it reported can move a score meaningfully, and at the 720 line it can be worth half a million dollars of loan amount. It has to be documented properly, and it has to be done early enough to be reported.
Two liability rules that move your ratio
Revolving accounts. The monthly payment on a revolving account with a balance must be included in your debt-to-income ratio, regardless of the number of months remaining. If the credit report shows no payment and the actual payment cannot be determined, a minimum payment may be calculated as the greater of $10 or 5% of the balance.
That 5% figure is why a card you intend to pay off next month is expensive right now. Pay it before the report is pulled.
Open-end and net thirty day accounts. If the report reflects one, the balance owing is subtracted from your liquid assets. It does not hit your ratio, it hits your reserves.
Tax liens and collections
Two hard rules:
- Payment plans on prior year tax liens or liabilities are not allowed. They must be paid in full.
- Cash-out proceeds from the subject transaction may not be used to satisfy judgments, tax liens, charge-offs or past-due accounts.
If you have an installment agreement with a taxing authority, that is a solve-it-first item, not a work-around item.
The order of operations
- Pull all three scores today. Find out which tier you are in.
- If you are within twenty points of 680 or 720, work the gap before applying.
- Unfreeze all bureaus.
- Pay revolving balances down and let them report.
- Open no new credit from application through closing.
- If you have a derogatory event, count the months. Four years is the line.
Common questions
What credit score do I need for a physician loan? 680 reaches 95% loan-to-value to $2,000,000 and 100% to $1,500,000. 720 reaches 100% to $2,000,000. The alternative adjustable program requires a 720 minimum.
Is it worth raising my score from 700 to 720? If you are borrowing above $1,500,000 with minimal down payment, that threshold is worth five hundred thousand dollars of loan amount on this program. It is usually the highest-return preparation available.
Will buying furniture before closing hurt me? It can end the approval. Inquiries in the most recent 90 days must be explained, and any new credit obtained must be verified and included in your debt-to-income ratio.
How long after a bankruptcy or foreclosure can I use a physician loan? Four years of seasoning is required for derogatory credit events.
I froze my credit. Is that a problem? It has to be undone. Frozen bureaus must be unfrozen and a current report with all three unfrozen is required.
Can I pay off a tax lien over time? Not on this program. Payment plans on prior year tax liens or liabilities are not allowed and must be paid in full.
Related reading
- Physician and medical professional home loans, the full index for this topic
- Physician Home Loans in Scottsdale: How Doctors Buy With No Down Payment and No Mortgage Insurance
- Physician Loan Down Payment: What 0%, 5% and 10% Actually Cost You
- Physician Loan Reserves: The Requirement That Quietly Decides Your Price Range
Why bring this file to us
- We check where you sit against the thresholds first. A few points below a tier is a fixable problem when you find it in month one.
- We handle frozen bureaus and rescores properly, both of which have specific documentation rules here.
- We tell you not to buy furniture yet, and the inquiry rule below is why.
- 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 and a Certified Mortgage Planner, NMLS #173141, originating mortgages 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.
Pull your scores before you talk to anyone. If you are sitting at 715 there is usually a legitimate way to reach 720, and it is worth real money on this program.
Program figures in this post come from the CMG Financial (NMLS #1820) guideline set named above, as published on the revision date given. CMG Financial is the parent company of EPiQ Lending. These figures 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.
