Physician mortgage loans: How doctor loans work and who qualifies
A physician mortgage loan is a specialty program for doctors and other qualifying medical professionals that trades a large down payment for flexible underwriting. Programs available through lenders in Align’s network typically charge no private mortgage insurance even with less down than a conventional loan needs to avoid it, and they discount the number that sinks most residents on a conventional loan: a deferred student loan reporting a $0 payment, which Fannie Mae’s rule lets a lender charge at 1% of the balance, $2,500 a month on $250,000 of medical school debt.1
Hypothetical example, not an offer. Actual rates, costs and payments vary.

Two more levers come with it: a signed employment contract can stand in for pay stubs 60 to 90 days before your start date, and loan ceilings run past the 2026 conforming loan limit of $832,750 that separates conventional underwriting from jumbo. Down payment tiers, rate structure and eligible professions are set by each lender, not by Align or any federal agency.
The catch is that the same flexibility makes it easy to over-borrow. Learn how physician mortgage loans price the down payment, how lenders treat student debt and employment contracts, and when the plain conventional loan is cheaper. If you’re still mapping the menu, start with our Loan Types & Programs guide.
Key takeaways:
- No mortgage insurance at 0% to 10% down: Conventional financing requires private mortgage insurance above 80% loan-to-value, and federal law doesn’t force it off until the balance reaches 78% of original value. Physician programs delete the line item.
- The student loan rule is the real differentiator: Fannie Mae lets a lender qualify a deferred, $0-payment student loan at 1% of the balance, $2,500 a month on $250,000 of medical school debt. Physician programs commonly exclude it or use the documented payment.
- Approval is not affordability: Fannie Mae’s automated underwriting approves debt-to-income up to 50%, and physician programs commonly quote around 45%. Both are ceilings, not budgets.
What is a physician mortgage loan?
A physician mortgage loan is a low- or no-down-payment home loan offered to licensed medical professionals that waives private mortgage insurance, discounts student debt in the qualifying math, and underwrites contract income instead of earnings history. It is a portfolio product, held on the lender’s balance sheet rather than sold to Fannie Mae or Freddie Mac.
That detail explains everything else. Because no agency buys these loans, no agency writes their rules: no handbook, no eligibility matrix, no announcement when a term changes. Every figure below is a market convention, a different thing from a rule, and worth confirming in writing with the lender.
Our guide to physician mortgages covers where the product sits, and the Specialty Financing hub covers the neighboring programs physicians weigh against it. This page goes deeper: the tiers, the debt math, and the guardrail.
How much do you put down on a physician loan?
Zero to 10% is the common band, and the number you get tracks loan size, not specialty. Physician programs price the down payment on a tier table: 100% financing typically holds to a first ceiling near $1 million to $1.25 million, then steps to roughly 95% around $1.5 million and 90% approaching $2 million. Breakpoints move from lender to lender.
The advertised savings is the missing mortgage insurance. On a conventional loan, putting down less than 20% means private mortgage insurance, and the premium scales with your loan-to-value, so it costs most when your down payment is smallest. Under the Homeowners Protection Act you can request cancellation once the balance is scheduled to reach 80% of original value, and, as long as you are current on payments, your servicer must terminate it automatically at 78%, and no later than the month after the midpoint of the amortization schedule, 15 years in on a 30-year loan, whether or not the balance got there. The CFPB explains what private mortgage insurance costs and when it drops off, and our guide to mortgage insurance covers the cancellation mechanics.
A physician program replaces that clock with nothing: no premium, no cancellation request, no midpoint. It is not the only route there. If your goal is avoiding mortgage insurance rather than putting nothing down, weigh the physician tier against low-down-payment mortgages and a piggyback mortgage, which splits financing across two liens to hold the first at or below 80%.
Why a deferred student loan counts as $2,500 a month
Because on a deferred loan Fannie Mae will not let a lender qualify you at $0. When a student loan sits in deferment or forbearance and the credit report shows a $0 payment, the rule gives two choices, a payment equal to 1% of the outstanding balance, or a fully amortizing payment calculated from documented loan terms. On $250,000 of medical school debt, the 1% path piles $2,500 a month onto your debt-to-income ratio. That single adjustment moves more approval capacity on a resident’s file than the down payment does.
There is an exception most physicians never hear about, worth checking before you assume you need a specialty program: if you are on an income-driven repayment plan and your lender documents that your actual payment is $0, Fannie Mae permits qualifying at $0. So the edge is real but narrower than the marketing suggests. It does the most work for residents and fellows in deferment or forbearance, much less for an attending already on a documented plan. The CFPB shows how student loan payments hit your debt-to-income ratio.
Physician programs answer the same question three ways: full exclusion of the deferred balance, the documented income-driven payment, or a smaller percentage of the balance than the conventional rule uses. Get the answer in writing before you compare rates. It is the figure most likely to decide whether the loan happens at all.
Physician loan vs. conventional loan: what actually differs
Five things differ, and only two are as lopsided as the sales sheet implies. The employment-contract advantage is smaller than most physicians expect, because conventional rules already allow a future start date.
| Feature | Physician mortgage loan | Conventional (conforming) |
|---|---|---|
| Down payment | 0% to 10% is common, tiered by loan size | 3% minimum on 97% LTV programs, each with its own gate. The standard 97% option requires at least one first-time home buyer, and HomeReady caps qualifying income at 80% of area median income, which most attending salaries clear |
| Mortgage insurance | None at any tier in most programs | Required above 80% LTV; cancels by request at 80% of original value, automatically at 78% for a borrower current on payments, and no later than the month after the amortization midpoint |
| Deferred student loans | Often excluded, or counted at the documented payment | 1% of the balance or a fully amortizing payment from documented terms; $0 allowed on a documented income-driven plan |
| Income documentation | Signed employment contract commonly accepted 60 to 90 days before the start date | Offer or contract allowed with a start date no later than 90 days after the note date, plus reserves |
| Interest rate structure | Frequently adjustable-rate; fixed options often priced at a premium | Typically fixed-rate; adjustable is a choice, not the default |
| Typical loan ceiling | Lender-set; zero-down tiers commonly top out near $1 million to $1.25 million, with ceilings higher at larger down payments | $832,750 for one unit under FHFA’s 2026 baseline; above that the loan becomes jumbo |
| Debt-to-income ceiling | Commonly quoted around 45% | Up to 50% through Desktop Underwriter |
Two rows deserve a second look. On income documentation, Fannie Mae already permits an employment offer or contract with a start date no later than 90 days after the note date. The catch is reserves: without a paystub before delivery, the lender must document six months of PITIA, or enough to cover liabilities through the start date plus one month. Six months of reserves on a $700,000 house is exactly the money a resident does not have, and waiving it is where the physician program earns its fee.
On loan ceiling, the conforming limit moves by design: federal law makes FHFA reset the baseline yearly, and an area gets an above-baseline limit only where 115% of its local median home value clears the baseline, set as a multiple of that area median value, capped at a ceiling of 150% of the baseline. For 2026 that is $832,750 and a $1,249,125 ceiling. Above the applicable limit a conventional loan becomes a non-conforming loan carrying jumbo standards, so weigh it against what a jumbo loan would demand.
What the student loan rule is worth, in dollars
On a file carrying $250,000 of medical school debt, the two treatments differ by roughly $2,100 a month of qualifying capacity. Say a first-year attending earns $18,000 a month gross, carries that balance deferred and reporting $0, and has a documented income-driven payment of $400 once she enrolls.2
- Conventional, still in deferment: The lender applies 1% of the balance, $2,500 a month charged against her ratio.
- Conventional, documented income-driven payment: The lender uses the actual $400. Same borrower, same debt, $2,100 of difference produced by paperwork.
- Physician program: Commonly excludes the deferred balance or uses that same documented payment, landing at or below the conventional best case.
Hypothetical example, not an offer. Actual rates, costs and payments vary.
Run it to the ceiling. At a 45% debt-to-income limit, $18,000 of gross income supports $8,100 of total monthly debt. Charge $2,500 against it and $5,600 is left for the mortgage and everything else; charge $400 and $7,700 is left. That gap is the whole product in one number, and it is why a resident who cannot get approved in March gets approved in June after enrolling in an income-driven plan, with no specialty loan at all.
How much student debt and income does a new physician bring to an application?
According to the AAMC’s October 2024 fact card for the class of 2024, built from its 2024 Graduation Questionnaire, a survey of graduating students, 71% of graduates had education debt, and the median among those with debt was $205,000 ($200,000 at public schools, $230,000 at private ones). The same card reports that 56% of graduates owed $200,000 or more, 23% owed $300,000 or more, and 63% planned to enter a loan forgiveness or repayment program (AAMC, Debt, Costs, and Loan Repayment Fact Card, October 2024).
The card lists a preliminary 2024 median first post-MD year stipend of $65,100, with a federal payment on that stipend of $354 a month under IBR. In its sample for $205,000 of Direct Loans, a graduate who used forbearance through a three-year residency and then the standard plan paid about $3,100 a month for ten years after training (same AAMC fact card).
Hypothetical example, not an offer. Actual rates, costs and payments vary.
Per the Bureau of Labor Statistics, the median annual pay for physicians and surgeons was $275,930 in May 2025, and residency typically lasts 3 to 9 years depending on the specialty (BLS Occupational Outlook Handbook, Physicians and Surgeons). Per the National Resident Matching Program, matched applicants learned at noon ET on March 20, 2026 where they would begin their clinical training (NRMP 2026 Main Residency Match results). That is the earliest point a new resident knows which housing market to shop. Our guide to buying a home with student loan debt covers the statements a lender will ask for.
Do FHA loans count deferred student loans the same way?
No. FHA uses half the Fannie Mae percentage. Under HUD Mortgagee Letter 2021-13, dated June 17, 2021 and effective for FHA case numbers assigned on or after August 16, 2021, the lender must use the payment on the credit report or the actual documented payment when it is above zero, or 0.5% of the outstanding balance when the credit report shows $0, whatever the payment status (HUD Mortgagee Letter 2021-13).
The same letter lets the lender leave a student loan payment out only where written documentation from the student loan program, creditor or servicer shows the balance has been forgiven, canceled, discharged or otherwise paid in full (ML 2021-13, Required Documentation).
Hypothetical example, not an offer. A $250,000 balance reporting $0, and the monthly figure each rule puts into the ratio:
| Rule | Monthly figure in the ratio |
|---|---|
| Fannie Mae, deferred or in forbearance, 1% of the balance | $2,500 |
| FHA, credit report shows $0, 0.5% of the balance | $1,250 |
| Documented income-driven payment from the example above | $400 |
Sources: Fannie Mae Selling Guide B3-6-05, Monthly Debt Obligations (topic dated August 5, 2026); HUD Mortgagee Letter 2021-13 (June 17, 2021).
The FHA loan limit is the other catch for physicians. Per HUD’s December 11, 2025 announcement, the 2026 FHA one-unit limit runs from a $541,287 floor to a $1,249,125 ceiling, and every Michigan county sits at the floor (HUD No. 25-145, 2026 loan limits). A Michigan purchase financed above $541,287 is outside FHA. See FHA loans, FHA loan limits and conventional loans. Align Lending is not affiliated with HUD or FHA.
What changed for medical student loans on July 1, 2026?
Federal borrowing for professional students was rewritten. Per the University of Illinois College of Medicine’s July 17, 2025 summary of the One Big Beautiful Bill Act, the law eliminates the Graduate PLUS loan program effective July 1, 2026, caps annual federal loan limits for professional students at $50,000 and the aggregate at $200,000, and requires borrowers in ICR, PAYE or SAVE to move to another plan (current IBR, a current standard plan, or RAP) by July 1, 2028 (UI College of Medicine summary). For scale, the AAMC reported a median four-year cost of attendance for the class of 2025 of $286,454 at public schools and $390,848 at private ones (AAMC, June 25, 2025).
The new Repayment Assistance Plan has no $0 payment. According to the Illinois Attorney General’s Student Loan Helpline guide, RAP was created on July 4, 2025, and the guide said it should be available to Direct Loan borrowers by July 1, 2026; the guide describes it as the only income-driven plan for loans taken out after June 30, 2026. It charges up to 10% of adjusted gross income, subtracts $50 a month for each dependent, and never goes below $10 a month. Its table shows $250 a month at $60,000 of AGI and $350 at $70,000, with no dependents (Illinois Attorney General, Repayment Assistance Plan).
For a borrower on RAP, that floor changes which rule applies. Fannie Mae’s $0 path needs documentation that the actual payment is $0, which RAP’s $10 minimum (per the Illinois Attorney General guide) rules out, so the lender works from the documented payment (Fannie Mae B3-6-05). Under FHA’s rule, any documented payment above zero replaces the 0.5% formula (HUD ML 2021-13). The floor applies only to RAP: a borrower still on IBR whose documented payment is $0 is not affected by it, and a resident in deferment or forbearance keeps the 1% or 0.5% figure. Settle the repayment plan before you ask for a preapproval, and use our guide to improving your debt-to-income ratio for the other levers.
Physician loan requirements beyond your specialty
The profession list is the most variable term in the product, MDs and DOs everywhere, dentists and oral surgeons, veterinarians, optometrists and podiatrists at most shops, pharmacists, physician assistants and nurse practitioners at some. Four other requirements decide the file.
- Career stage sets the tier, not eligibility: Residents, fellows and attendings all qualify at most shops, but down payment minimums and maximum loan amounts are tighter for residents and loosen at attending status.
- Credit still governs pricing: Flexible underwriting on debt is not flexible underwriting on payment history. Programs commonly want scores in the 700s for the best tiers, and payment history is the heaviest FICO input at 35%, followed by amounts owed at 30%. Know what lenders see in your credit score first.
- Occupancy is close to universal: Owner-occupied primary residences, usually one to two units. A rental or second home needs standard financing.
- The contract is the approval: Any change to the start date, employer or compensation triggers re-underwriting. Tell your loan officer the day it happens.
- Practice owners sit elsewhere: A partnership stake changes how income is documented, see self-employed borrower options.
The guardrail: an approval is not a budget
Take the maximum payment a physician program approves and cut it by roughly a third before you shop. In the scenario above, a 45% ceiling on $18,000 of gross income left $7,700 a month for housing and any other debt, so for a borrower carrying nothing but the student loan, $7,700 is the housing ceiling. A housing payment at or below 28% of gross income (a budgeting convention, not a lending rule, and one no agency enforces) puts the same borrower near $5,040. The approval sits about $2,600 above the convention, and nothing in the underwriting will say so.
Hypothetical example, not an offer. Actual rates, costs and payments vary.
Three pressures make over-borrowing easy here:
- The discounted debt is still owed: A program that excludes $250,000 of student loans from the ratio has not excluded them from your checking account. The payment starts when deferment ends.
- Zero down means zero cushion: With no equity, a sale inside two or three years in a flat market can leave you bringing money to closing. If you expect to move after fellowship, that risk is real.
- Zero down is not zero cash: Closing costs and prepaid escrow still land on the table, see budgeting for closing costs and mortgage closing costs.
Timing is its own trap. Physicians relocating often need to buy before the old home sells, and a loan stretched to its ceiling removes every option for covering that gap, see bridge loans. If the program is not the right fit, the newer mortgage products lenders have rolled out for strong income and thin savings deserve a look, and revisit your mortgage preapproval whenever your employment picture moves.
Does the federal ability-to-repay rule apply to physician loans?
Yes. Regulation Z’s ability-to-repay rule, 12 CFR 1026.43, applies to any consumer credit transaction secured by a dwelling, with listed exceptions such as home equity lines of credit, timeshare loans and certain temporary or bridge loans (12 CFR 1026.43(a)). Portfolio loans are not among them. The creditor must consider eight factors, and the first is the consumer’s current or reasonably expected income or assets.
The CFPB’s official interpretation, comment 43(c)(2)(i)-3, says a creditor may rely on a consumer’s expected salary from a job the consumer has accepted, verified with a written statement from the employer, and its own example is a job that begins after the consumer receives an educational degree (CFPB, Official Interpretation of 12 CFR 1026.43).
Current debt obligations are one of the eight factors, and that is where a student loan sits, but the rule sets no percentage for one: the percentages above come from Fannie Mae and FHA, and a portfolio lender writes its own. That is why mortgage underwriting on a physician loan is worth asking about line by line. If the lender quotes an adjustable rate, our guide to adjustable-rate mortgage pros and cons explains how the first adjustment works.
What Michigan physicians should know
Michigan adds wrinkles worth real dollars, mostly calendar problems tied to the July start date most residency and fellowship contracts carry.
- One conforming limit statewide: No Michigan county carries a high-cost designation in FHFA’s 2026 county list, so all 83 sit at the $832,750 one-unit baseline. Above it, a purchase is jumbo territory statewide, the band where a physician program’s higher ceiling earns its keep near Detroit, Ann Arbor and Grand Rapids health systems.
- The principal residence exemption is worth up to 18 mills: Michigan exempts your principal residence from the tax a local school district levies for school operating purposes, and state law caps that levy at 18 mills. On a $450,000 purchase whose taxable value uncaps near $225,000, that is about $4,050 a year, roughly $337 a month of escrow not counting against your ratio.3
- The June 1 deadline collides with a July start: The exemption affidavit must be on file by June 1 for the summer levy and November 1 for the winter levy. Close in late June or July and you typically miss the June deadline, so your first summer bill can arrive at the non-homestead rate. File it at closing, with the separate property transfer affidavit due within 45 days.
- Budget from the uncapped number: A sale uncaps taxable value to the state equalized value the following year, and the state constitution caps assessments at 50% of true cash value. The seller’s bill is not the bill you inherit.
Can a Michigan loan repayment award help a physician qualify?
Over time, not on the application date. Per the Michigan Department of Health and Human Services, the Michigan State Loan Repayment Program provides up to $300,000 in tax-free funds to repay educational debt over a period of up to ten years, and its service obligations require full-time primary care in Health Professional Shortage Areas at not-for-profit clinics for two years (MDHHS, MSLRP overview).
Neither underwriting rule above lists a pending repayment award. FHA’s exclusion needs written proof that the balance has been forgiven, canceled, discharged or paid in full, and Fannie Mae works from the reported payment, the documented payment, the 1% figure or a fully amortizing payment (HUD ML 2021-13; Fannie Mae B3-6-05). Bring the MSLRP agreement and the latest servicer statement.
A second Michigan point applies to fellows who move. Per the Michigan Department of Treasury, the principal residence exemption covers the one place where an owner has a true, fixed and permanent home, and Treasury posted that PRE audits and denials begin April 24, 2026 (Treasury, Principal Residence Exemption). A residency house kept as a rental after the move cannot keep the exemption alongside the new home. Our guides to the homestead exemption and property tax assessments cover the filing and the bill.
How Align handles specialty financing
Specialty loans are where a single bank's menu runs out. Align places HomeStyle and FHA 203(k) renovation loans, non-warrantable condo loans, DSCR loans and standalone HELOCs through multiple wholesale lenders.
Samantha handles these files herself, from the first conversation to the closing table, with a processor supporting her behind the scenes. Complicated and impossible are not the same thing.
FAQ: Physician mortgage loans
Here are answers to common questions about physician mortgage loans.
Who qualifies for a physician mortgage loan?
Eligibility usually extends beyond MDs and DOs to dentists, veterinarians, optometrists, podiatrists, and sometimes pharmacists, physician assistants and nurse practitioners. Residents, fellows and attendings qualify at most shops, though loan limits and down payment minimums differ by career stage. Confirm the list before you shop, and weigh it against choosing the right mortgage type.
How do physician loans treat student loan debt?
Most either exclude deferred student loans entirely or use the actual income-driven repayment amount, rather than the 1% of the balance Fannie Mae applies to a deferred loan reporting $0. On $250,000 of debt, that is worth more than $2,000 a month of qualifying capacity, usually what makes the approval possible during residency. Our guide to the debt-to-income ratio shows the math.
Are physician mortgage rates higher than conventional rates?
Sometimes, but not always. Many are adjustable-rate loans priced competitively in the initial fixed period, while fixed-rate options often carry a modest premium. Because you are also avoiding mortgage insurance, the right comparison is total monthly payment, not rate alone. Our comparison of fixed-rate versus adjustable-rate mortgages explains the adjustment caps.
Should a physician use a conventional loan instead?
Often yes, once you have a down payment near 20% and settled income. A conventional loan at 20% down carries no mortgage insurance either, usually offers fixed-rate pricing, and does not tempt you toward a larger balance. Physician loans earn their keep when the down payment is small, the student debt is large, or you must close before your start date. Above the conforming limit, the alternative is a jumbo loan, read our jumbo loan tips first.
Do physician loans have prepayment penalties?
Only within narrow federal limits. Under 12 CFR 1026.43(g), a covered mortgage may carry a prepayment penalty only if it is otherwise permitted by law, its APR cannot increase after closing, it is a qualified mortgage, and it is not a higher-priced mortgage loan. Even then the penalty ends after three years and is capped at 2% of the balance prepaid in the first two years and 1% in the third. An adjustable-rate loan fails the fixed-APR test.
Can a physician use an employment contract that still has conditions, like licensing or credentialing?
The conditions have to be cleared before closing. Fannie Mae’s Selling Guide B3-3.3-03 (topic dated October 7, 2026) requires a fully executed, non-contingent offer or contract naming the employer, position, pay and start date. On the option with no paystub before delivery, the start date can fall up to 30 days before the note date, the lender must confirm before closing that all conditions of employment are satisfied, and a verbal verification of employment is required on both options.
What credit score do you need for a physician loan?
Each physician program sets its own minimum. For a conventional comparison, Fannie Mae’s Selling Guide B3-5.1-01 (topic dated April 22, 2026) sets a 620 minimum representative score for manually underwritten fixed-rate loans and 640 for adjustable-rate loans, requires no minimum on a Desktop Underwriter casefile, and lists classic FICO, VantageScore 4.0 and FICO 10T as the approved models. See what counts as a good credit score to buy a house.
When do you get a Loan Estimate on a physician loan?
Within three business days of the lender receiving your application, according to the CFPB, which describes it as a three-page form with the loan’s key terms and estimated costs. The CFPB lists the loans that get Truth in Lending disclosures instead, such as HELOCs and manufactured home loans not secured by real estate, and a purchase loan like this one is not among them. Run it through our Loan Estimate check, or compare two side by side.
The bottom line on physician mortgage loans
A physician mortgage loan waives private mortgage insurance at 0% to 10% down, accepts a signed employment contract in place of pay stubs 60 to 90 days before your start date, discounts the student debt conventional underwriting can charge at 1% of the balance ($2,500 a month on $250,000) and reaches past the 2026 conforming loan limit of $832,750. None of those terms is a rule; every one is a lender’s policy, subject to change. Before taking the specialty program, price the conventional loan with a documented income-driven payment, and compare total monthly cost rather than rate against rate.
Hypothetical example, not an offer. Actual rates, costs and payments vary.
If you’re ready to see whether a physician loan or a conventional loan actually costs you less, talk to Align Lending. We’ll shop your scenario across our lender network and put both structures in front of you side by side. Call 248-506-5727 or book a time with Samantha.
Footnotes:
1. Physician mortgage program terms described in this article. Down payment tiers, the mortgage insurance waiver, the contract-start closing window, debt-to-income ceilings and maximum loan amounts. Are program features offered by individual wholesale lenders in Align Lending’s network. They are not established, insured or endorsed by Fannie Mae, Freddie Mac, FHFA or any government agency. They vary by lender, by career stage and by loan amount, are subject to individual qualification, and change without notice. Confirm current terms in writing with your lender. Return to text.
2. Example figures in this article are hypothetical and for educational purposes only; they do not constitute an advertisement of credit terms or a rate quote under federal or state lending laws. The $18,000 monthly income, $250,000 student loan balance, $400 income-driven payment and the resulting qualifying capacity are illustrations, not estimates of your file. Your ratio, rate and total monthly payment depend on your application, credit profile, loan amount, property and market conditions, and will be itemized on your Loan Estimate. Return to text.
3. This is general information, not tax advice. The $450,000 purchase price, $225,000 taxable value and resulting $4,050 annual figure are illustrative; assessed and taxable values are determined by your local assessor, millage rates vary by community and by year, and the 18-mill figure is the statutory cap on the school operating levy rather than a guaranteed savings amount. Consult a qualified tax professional and your local assessor about your situation. Return to text.
Figures current as of August 2026; verify with the linked source before relying on them. Sources: 2026 one-unit baseline conforming loan limit value of $832,750, the $1,249,125 high-cost area ceiling equal to 150% of the baseline, the rule that an area receives an above-baseline limit only where 115% of the local median home value exceeds the baseline, with HERA setting that area’s limit as a multiple of the area median home value subject to the 150% ceiling, the HERA requirement that FHFA adjust the baseline annually, and the absence of any high-cost designation among Michigan’s 83 counties, Federal Housing Finance Agency, “FHFA Announces Conforming Loan Limit Values for 2026” and the 2026 conforming loan limit county list. Private mortgage insurance required on conventional loans with a down payment of less than 20%, and available payment structures, Consumer Financial Protection Bureau. Borrower-requested cancellation when the principal balance is scheduled to reach 80% of the home’s original value, automatic termination at 78% of original value, and termination the month after the midpoint of the amortization schedule. Each conditioned on the borrower being current on payments, Homeowners Protection Act of 1998; Consumer Financial Protection Bureau, “When can I remove private mortgage insurance (PMI) from my loan?” Debt-to-income ratio defined as all monthly debt payments divided by gross monthly income, Consumer Financial Protection Bureau. Student loans in deferment or forbearance qualified using either 1% of the outstanding balance or a fully amortizing payment calculated from documented loan terms, and a $0 payment permitted where the lender documents an actual $0 payment under an income-driven repayment plan, Fannie Mae Selling Guide B3-6-05. Employment offers and contracts permitted where the start date is no later than 90 days after the note date, with six months’ PITIA reserves or resources covering liabilities from the note date through the start date plus one month where a paystub is not obtained prior to delivery, Fannie Mae Selling Guide B3-3.3-03. Maximum debt-to-income ratio of 50% for Desktop Underwriter loan casefiles, Fannie Mae Selling Guide B3-6-02. HomeReady financing to a maximum 97% LTV and the requirement that total annual qualifying income not exceed 80% of the area median income for the property’s location, Fannie Mae Selling Guide B5-6-01; the requirement that at least one borrower be a first-time home buyer on a standard 97% LTV purchase transaction, Fannie Mae, “97% LTV Options.” FICO score category weights of 35% payment history and 30% amounts owed for the general population, myFICO. Michigan principal residence exemption from the tax levied by a local school district for school operating purposes, and the June 1 (summer levy) and November 1 (winter levy) affidavit deadlines, MCL 211.7cc(1) and (2); the 18-mill cap on the school operating levy, MCL 380.1211(1). Taxable value uncapping to state equalized value in the calendar year following a transfer of ownership, MCL 211.27a; the 50%-of-true-cash-value assessment ratio, Michigan Constitution, Article IX, Section 3; buyer property transfer affidavit due within 45 days of transfer, MCL 211.27a(10).
This article is for informational purposes only and is not intended to provide legal, financial, or tax advice. Physician mortgage program terms are set by individual lenders, are not established or endorsed by any government agency, and change without notice; confirm current terms and figures with your lender and your Loan Estimate. Loan limits, property tax rates and program rules change and vary by property, county and lender; verify with the issuing agency and your local assessor. Figures shown are illustrative, are not a rate quote or an offer of credit, and are subject to change. Align Lending is an independent Michigan mortgage broker, NMLS #2041154.
Sources
Every outside source this guide links to, in the order it appears. How we choose and check sources
- What private mortgage insurance costs and when it drops offConsumer Financial Protection Bureau
- How student loan payments hit your debt-to-income ratioConsumer Financial Protection Bureau
- AAMC, Debt, Costs, and Loan Repayment Fact Card, October 2024students-residents.aamc.org
- BLS Occupational Outlook Handbook, Physicians and Surgeonsbls.gov
- NRMP 2026 Main Residency Match resultsnrmp.org
- HUD Mortgagee Letter 2021-13U.S. Department of Housing and Urban Development
- Fannie Mae Selling Guide B3-6-05, Monthly Debt Obligations (topic dated August 5, 2026)Fannie Mae Selling Guide
- HUD No. 25-145, 2026 loan limitsU.S. Department of Housing and Urban Development
- UI College of Medicine summarymedicine.uic.edu
- AAMC, June 25, 2025aamc.org
- Illinois Attorney General, Repayment Assistance Planillinoisattorneygeneral.gov
- What lenders see in your credit scoreFICO
- 12 CFR 1026.43(a)law.cornell.edu
- CFPB, Official Interpretation of 12 CFR 1026.43Consumer Financial Protection Bureau
- MDHHS, MSLRP overviewState of Michigan
- Treasury, Principal Residence ExemptionState of Michigan
- Selling Guide B3-3.3-03Fannie Mae Selling Guide
- Selling Guide B3-5.1-01Fannie Mae Selling Guide
- CFPBConsumer Financial Protection Bureau
- FHFA Announces Conforming Loan Limit Values for 2026Federal Housing Finance Agency
- Homeowners Protection Act of 1998law.cornell.edu
- MCL 211.7cc(1) and (2)Michigan Legislature


