Medical Resident & Fellow Mortgages

Medical resident and fellow mortgage from a lender who reads signed forward attending contracts, training-period IDR documentation, sign-on and loan-repayment packages, residency completion timing, and PSLF eligibility as one income picture.

Residents in their final year of training and fellows finishing subspecialty programs are in a unique mortgage position: current resident or fellow W-2 income runs $60K–$80K (PGY-1 through PGY-7+), but the signed forward attending contract in hand often documents $250K–$700K+ of future attending compensation starting 60–120 days from contract signature. Layered onto this is $200K–$450K of federal medical-school student loans on income-driven repayment with actual training-period payments of $0–$500/month, possible PSLF qualifying payment accrual during nonprofit hospital residency, hospital sign-on bonuses ($25K–$300K for specialty attendings), employer loan-repayment-assistance ($25K–$50K annually), and forward attending sign-on and relocation packages. Physician/Doctor Loan programs with signed-contract qualifying allow residents and fellows to close on a home up to 60–90 days pre-start using the signed attending contract as documented future income, with no-down or low-down structure (0–10% down), no PMI, and IDR-friendly DTI. Generalist lenders look at the current $65K resident W-2 and refuse. We qualify on the signed forward contract.

Talk to Our Team See how signed-contract qualifying works

Broker NMLS #1072866 · Specialist in signed-contract physician loans, residency-completion timing, fellowship-to-attending close coordination, & PSLF-aware resident mortgages

$60K-$80K

Typical PGY-1 through PGY-7+ U.S. medical resident and fellow W-2 stipend (varies by city, sponsoring institution, and training year)

$200K-$450K

Typical medical-school federal student loan balance carried into and through residency

60-90 days

Window for signed-contract pre-start close under Physician/Doctor Loan programs (close before residency or fellowship ends)

B3-6-05

Fannie Mae rule allowing actual IDR payment ($0-$500/month typical during training) instead of 1% of $200K-$450K balance

Stairway Mortgage qualifies medical residents and fellows on the right income picture for their stage — Physician/Doctor Loan signed-contract qualifying using the signed forward attending employment contract documenting future W-2 base salary, sign-on bonus, loan-repayment-assistance, and RVU productivity bonus structure up to 60–90 days pre-start under Fannie Mae B3-3.1-01 forward-employment treatment; current resident or fellow W-2 stipend under Fannie Mae B3-3.1-01 as continuing employment income when not yet close to residency end; income-driven repayment (PAYE, SAVE, IBR) student loan payment from Federal Student Aid documented through servicer statement counted in DTI under Fannie Mae B3-6-05 instead of 1 percent of the medical-school loan balance; PSLF qualifying payment accrual during nonprofit hospital residency that reduces effective long-term student loan exposure; resident moonlighting W-2 from secondary hospitals or urgent care that aggregates as supplementary income under B3-3.1-01; co-borrower qualifying with an attending spouse where applicable; FHA conventional alternatives for tight-cash residents who need maximum down-payment flexibility; and forward attending sign-on bonus, relocation reimbursement, and multi-year loan-repayment-assistance treated as continuing employer compensation when contract documentation supports continuation provisions. A PGY-2 internal medicine resident planning ahead for the post-residency purchase, a PGY-3 family medicine resident with signed attending contract for July start, an orthopedic chief resident finishing 5-year residency with signed fellowship contract, a final-year cardiology fellow finishing subspecialty training, and a J-1 visa resident on waiver pathway each get qualified using the method that fits their actual structure. We pick the right door before we quote. Or skip ahead: browse every loan program, run numbers on 100+ mortgage calculators, or check today's rates. For the parent hub and other medical professional paths, see our medical professionals mortgage hub.

01 · Resident & fellow mortgage at a glance

Key facts every medical resident and fellow should know before applying for a mortgage.

Signed-contract

Physician/Doctor Loan signed-contract qualifying allows residents and fellows with signed forward attending contracts to close on a home up to 60–90 days pre-start using the signed contract as documented future income. This is the single most important qualifying mechanic for graduating residents and fellows.

B3-6-05 IDR

Under Fannie Mae B3-6-05, actual IDR payment from Federal Student Aid plans counts in DTI. Training-period IDR payments often run $0–$500/month against $200K–$450K balances vs $2,000–$4,500 the 1% rule imposes — swinging $500K–$1M of qualifying.

ACGME

The Accreditation Council for Graduate Medical Education (ACGME) accredits U.S. medical residency and fellowship programs. ACGME-accredited training documents the residency or fellowship status for mortgage qualifying. Residency duration varies from 3 years (family medicine) to 7+ years (neurosurgery, cardiothoracic surgery).

PSLF

Residents employed by 501(c)(3) nonprofit hospitals or government hospitals (VA, Indian Health Service, county hospitals) qualify for Public Service Loan Forgiveness qualifying payment accrual during training. The 10-year PSLF clock starts during residency for eligible employers.

02 · Where you are in your training journey

Resident and fellow mortgage solutions for every training stage.

Each stage of medical training has its own qualifying logic. A PGY-2 resident considering a long-term housing plan has a different mortgage path than a graduating PGY-3 with signed attending contract starting July 1, or a final-year cardiology fellow with signed attending contract starting September with $200K sign-on bonus and forward loan-repayment-assistance.

Early-stage resident (PGY-1 — PGY-2)

"In the first two years of residency. Current resident W-2 income with $200K-$400K of medical school student loans on IDR. Planning ahead for the post-residency purchase."

Current annual income $60K–$75K W-2 resident stipend
$200K–$400K federal student loans on PAYE or SAVE
Conventional with B3-6-05 IDR-aware DTI OR Physician Loan
Typical purchase range: $250K–$500K based on current income

See early-resident mechanics

Mid-residency (PGY-3 — PGY-4)

"In the middle years of residency. Beginning to think about attending career path. May be considering fellowship vs direct attending, or signing first attending contract for after residency."

Current annual income $65K–$78K W-2 resident stipend
Resident moonlighting may add $20K–$40K supplementary W-2
PSLF qualifying payments accruing if nonprofit hospital
Physician Loan or Conventional with B3-6-05 IDR-aware DTI

See mid-residency mechanics

Graduating resident (final year)

"Final year of residency. Signed attending contract or signed fellowship contract in hand. Coordinating July move from training site to attending location or fellowship site."

Signed forward attending contract: $250K–$550K base + sign-on
Pre-start close window: up to 60-90 days before July start
Physician/Doctor Loan with signed-contract qualifying
Typical purchase range: $600K–$1.4M based on signed attending

See graduating-resident mechanics

Subspecialty fellow (PGY-4 through PGY-7+)

"In subspecialty fellowship training. 1-3 year programs in cardiology, GI, pulmonary/critical care, surgical subspecialties, etc. Possibly signed attending contract for post-fellowship start."

Current annual income $70K–$85K W-2 fellow stipend
If final-year fellow with signed attending: $325K–$700K forward
Higher specialty signing bonuses ($100K–$500K)
Physician/Doctor Loan with signed-contract qualifying typical

See fellow mechanics

Final-year fellow with signed attending contract

"Final year of fellowship. Signed attending contract for post-fellowship start. Coordinating relocation from fellowship site to attending location. Pre-start close coordination critical."

Signed forward attending contract: $325K–$700K+ specialty-dependent
Pre-start close window: 60-90 days before attending start
Physician/Doctor Loan with signed-contract qualifying
Typical purchase range: $850K–$2M+ based on specialty

See final-year fellow mechanics

03 · The qualification mechanics

How we calculate qualifying income for your resident or fellow mortgage.

Four methods cover almost every resident and fellow file we’ve closed. The right method depends on your training year, whether you have a signed forward attending contract, your IDR enrollment status, and whether a co-borrower applies.

Method 1 — Signed forward attending contract qualifying (the graduating-resident default)

The signature qualifying method for graduating residents and final-year fellows. Under Physician/Doctor Loan programs, the signed forward attending employment contract documents future W-2 base salary, sign-on bonus, loan-repayment-assistance, and RVU productivity bonus structure. The lender treats the signed contract as documented future income, allowing close up to 60–90 days pre-start. Combined with low-down or no-down structure (0–10% down even on jumbo amounts), no PMI requirement, and IDR-friendly DTI treatment under Fannie Mae B3-6-05, this becomes the highest-leverage qualifying mechanic available to medical professionals. Most physician borrowers using this method close $700K–$1.5M purchases as their first home.

Method 2 — Current resident or fellow W-2 + IDR-aware DTI (the early-stage path)

For residents and fellows not yet close to graduation and not yet holding signed forward attending contracts. Current W-2 stipend ($60K–$85K depending on training year) qualifies under Fannie Mae B3-3.1-01 as continuing employment income with 24-month average. The critical mechanic is B3-6-05 IDR documentation: the actual servicer-statement payment ($0–$500/month typical at resident income) counts in DTI instead of 1% of the $200K–$450K balance. Without B3-6-05 treatment, the 1% rule alone often disqualifies residents; with B3-6-05, residents qualify for $250K–$500K mortgages on current income.

Method 3 — Resident W-2 + moonlighting + co-borrower stacking

For residents with substantial moonlighting income and/or a co-borrower (commonly an attending spouse). Resident moonlighting W-2 from secondary hospitals or urgent care commonly adds $15K–$40K of supplementary income. Under Fannie Mae B3-3.1-01, the moonlighting W-2 qualifies with 24-month average. Co-borrower files combine W-2s, 1099s, and any S-corp or partnership distributions from both parties. For residents married to attending spouses (common scenario), the joint qualifying picture often supports $1M–$2M+ purchases even on a resident-period file.

Method 4 — FHA conventional alternative for tight-cash residents

For residents who cannot access Physician/Doctor Loan low-down structure (rare credit score issue or geographic lender availability) and who need maximum down-payment flexibility. FHA loans allow 3.5% down with credit scores down to 580, accept gift funds liberally, and apply standard B3-6-05 IDR treatment to student loans. FHA carries mortgage insurance premium (MIP) costs that Physician Loans avoid, so it’s typically the second-choice alternative when Physician Loan options aren’t available. We compare cost over the expected hold period before recommending.

04 · What generalist underwriting misses

The income most lenders refuse to count on a resident or fellow file.

Six income facts that show up consistently on working resident and fellow files and that generalist lenders typically either ignore, mis-categorize, or refuse to apply correctly. Each one is documentable; the lender just has to read the signed forward contract structure, IDR documentation, and PSLF context properly.

Signed forward attending contract qualifying (60-90 days pre-start)

Physician/Doctor Loan programs treat signed forward attending employment contracts as documented future income, allowing close up to 60–90 days pre-start. The contract documents future W-2 base salary, sign-on bonus, RVU schedule, and loan-repayment provisions. For a graduating resident with $65K current W-2 and a $325K signed attending contract effective July 1, the lender qualifies on the $325K forward income for a close in May, June, or July. Generalist lenders refuse this entirely, insisting on 6 months of post-start W-2 history before they’ll qualify the new attending income.

Federal student loan IDR payment at $0-$500/month (B3-6-05)

Medical school plus residency leaves graduating residents with $200K–$450K of federal student loans typically on income-driven repayment (PAYE, SAVE, IBR). At resident or fellow income, the IDR-calculated monthly payment commonly runs $0–$500/month vs the $2,000–$4,500 that 1% of balance imposes. Under Fannie Mae B3-6-05, the actual servicer-statement payment counts in DTI. This single rule swings $500K–$1M of qualifying loan amount for residents and fellows.

PSLF qualifying payment accrual during nonprofit hospital residency

Residents employed by 501(c)(3) nonprofit hospitals or government hospitals (VA, Indian Health Service, county hospitals) accrue PSLF qualifying payments during residency. The 10-year PSLF clock starts in residency for eligible employers. For residents on PAYE making $0–$500/month payments during training, PSLF qualifying payment accrual is essentially free — the residency years count toward the 120-payment threshold without meaningful out-of-pocket cost.

Forward attending sign-on, loan-repayment, and relocation packages

Graduating residents and fellows receive hospital sign-on bonuses ($25K–$300K depending on specialty — psychiatry, primary care, family medicine, surgical specialties, and rural settings top the tables), employer loan-repayment-assistance commonly $25K–$50K annually for multi-year commitments at rural and underserved settings, and relocation reimbursement $10K–$30K. These benefits qualify as continuing employer compensation under B3-3.1-01 when the contract documents multi-year continuation.

Resident moonlighting W-2 supplementary income

Senior residents (typically PGY-3+) commonly moonlight at secondary hospitals, urgent care, or community emergency departments for supplementary income. Annual moonlighting W-2 runs $15K–$45K depending on specialty and shift volume. Under Fannie Mae B3-3.1-01, moonlighting W-2 qualifies as continuing employment income with 24-month average. Generalist lenders may treat moonlighting as "irregular" and exclude entirely.

Residency-completion timing and pre-start close coordination

U.S. residency programs end in late June with attending positions typically starting July 1 or July 15. Fellowship programs commonly end mid-year (July, August, or September depending on subspecialty). Pre-start close coordination is essential to avoid a 1-3 month rental gap between training end and attending start. Physician/Doctor Loan signed-contract qualifying allows close 60-90 days pre-start, enabling residents to close in April, May, or June and move directly to the new attending location.

05 · Match the program to your training stage

Which loan program fits your resident or fellow mortgage situation.

Seven loan-program categories cover essentially every resident and fellow file we’ve closed. The mix tilts heavily toward Physician/Doctor Loan with Signed-Contract Qualifying for graduating residents and final-year fellows (the signature product for this stage).

Physician/Doctor Loan w/ Signed-Contract Qualifying (primary)

Graduating residents and final-year fellows pre-start
Qualify on signed attending contract up to 60-90 days pre-start
Low-down or no-down (0-10%), no PMI, IDR-friendly DTI

Best for: Graduating resident or fellow

Physician/Doctor Loan w/ Current Income

Mid-residency residents without signed attending contract yet
Qualifies on current resident W-2 + B3-6-05 IDR
Low-down structure with no PMI

Best for: Mid-residency w/o forward contract

Conventional Conforming (IDR-aware)

Residents with current W-2 and student loan IDR
Fannie Mae B3-6-05 uses actual IDR payment in DTI
Loan limits to $766,550 (FL) 2024-25

Best for: Resident under conforming limit

Conventional Jumbo (specialty attending)

Graduating residents with high-paying specialty attending contracts
Forward attending W-2 of $400K–$700K+ specialty income
Combines signed-contract qualifying with jumbo loan amounts

Best for: High-tier specialty attending

Multi-Source W-2 (resident + moonlighting)

Residents with substantial moonlighting W-2 supplementation
B3-3.1-01 stacking of primary resident + moonlight W-2s
2-year history of moonlighting required

Best for: Moonlighting senior resident

Co-Borrower with Attending Spouse

Residents married to attending spouses (common scenario)
Joint qualifying combines resident W-2 + spouse attending W-2/K-1
Spouse’s established attending income drives qualifying capacity

Best for: Resident w/ attending spouse

FHA Conventional Alternative

Tight-cash residents needing maximum down-payment flexibility
3.5% down minimum, gift funds liberally accepted
MIP costs higher than Physician Loan — compare carefully

Best for: Tight-cash resident fallback

06 · Why this mortgage requires specialty expertise

The resident and fellow mortgage in context: 6 forces shaping how trainees qualify.

Medical resident and fellow mortgage qualifying sits at the intersection of residency duration variability across specialties, the Match Day to attending start timing cadence, ACGME accreditation context, federal student loan IDR and PSLF dynamics, J-1 visa international medical graduate considerations, and SAVE plan regulatory flux. Each force shapes what a working trainee’s qualifying picture looks like.

Force 1 — Residency duration variability across specialties

U.S. medical residency duration varies substantially across specialties: family medicine and internal medicine commonly run 3 years; pediatrics 3 years; psychiatry 4 years; OB-GYN 4 years; anesthesiology 4 years; general surgery 5 years; orthopedic surgery 5 years; urology 5 years; otolaryngology 5 years; neurosurgery 7 years; cardiothoracic surgery 6-7 years. Subspecialty fellowships add 1-3 additional years. The mortgage implication: graduating residents enter attending positions at age 29-36 depending on specialty, with corresponding life-stage timing for first-home purchase. Specialty determines both the timing and the income tier of the forward attending contract.

Force 2 — Match Day and the June/July relocation timing

The National Resident Matching Program (NRMP) Match Day falls on the third Friday of March each year, with residency positions announced and attending positions for graduating residents signed in the months following. Residency programs end in late June with attending positions starting July 1 or July 15. The result: every June, thousands of graduating residents nationally need housing coordination at new attending locations. The mortgage implication: signed-contract pre-start close timing in April through June is the standard scenario for graduating residents.

Force 3 — ACGME accreditation and training documentation

The Accreditation Council for Graduate Medical Education (ACGME) accredits U.S. medical residency and fellowship programs. ACGME accreditation status documents the legitimacy of the training program for mortgage qualifying purposes. Training documentation typically includes the residency or fellowship program letter confirming current status, expected completion date, and ACGME-accredited specialty. We work with the program coordinator to obtain the necessary letters for the underwriting file.

Force 4 — Federal student loan IDR and SAVE plan regulatory dynamics

The federal income-driven repayment landscape has shifted substantially in recent years. The SAVE plan introduced in 2023 offered the lowest IDR payment formula but has faced ongoing legal challenges through 2024-2025. PAYE and IBR plans remain available. For residents and fellows, the choice of IDR plan affects the monthly payment amount that counts under Fannie Mae B3-6-05 in mortgage DTI calculation. We work with the borrower to ensure the IDR enrollment is current and the servicer-statement payment supports qualifying.

Force 5 — PSLF for nonprofit hospital residency

Public Service Loan Forgiveness eligibility during residency depends on the sponsoring hospital’s 501(c)(3) nonprofit or government status. Approximately 70% of U.S. teaching hospitals are nonprofit or government, meaning the majority of residents accrue PSLF qualifying payments during training without realizing it. The 10-year PSLF clock starts in residency for eligible residents. Residents planning to remain at nonprofit hospitals through attending years often achieve forgiveness within 4-6 years of attending practice (residency years plus attending years totaling 120 qualifying payments).

Force 6 — J-1 visa international medical graduate considerations

A substantial share of U.S. medical residents and fellows are international medical graduates (IMGs) on J-1 visas. The J-1 visa creates a 2-year home country residency requirement that residents typically resolve through the J-1 waiver program (Conrad State 30, Appalachian Regional Commission, Delta Regional Authority, or Department of Health and Human Services waivers). The mortgage implication: J-1 residents finishing training and entering attending positions through J-1 waivers carry additional documentation requirements (waiver approval, 3-year underserved area service commitment) but qualify for mortgages the same as U.S. citizen residents with proper documentation.

07 · The mortgage shifts across training years

Resident and fellow mortgage by training stage.

A timeline view of how the right mortgage program changes as you progress from early residency through final-year resident with signed attending contract to final-year fellow about to start subspecialty attending position.

PGY-1 — PGY-2

Early-stage resident

Comp profile: $60K–$75K W-2 resident stipend. Dominant qualifying method: Conventional with B3-6-05 IDR-aware DTI OR Physician/Doctor Loan with current income. Common purchase: $250K–$500K based on current resident income. Watch-out: $200K–$400K of federal student loans require IDR enrollment AND properly-documented servicer statement showing actual monthly payment ($0–$300/month typical at PGY-1/PGY-2 income) for B3-6-05 treatment. Make sure IDR recertification is current. PSLF qualifying payments accruing if nonprofit hospital.

PGY-3 — PGY-4

Mid-residency resident

Comp profile: $65K–$78K W-2 resident stipend possibly plus $15K–$40K moonlighting W-2. Dominant qualifying method: Physician/Doctor Loan with current income or Conventional with B3-6-05 IDR-aware DTI. Common purchase: $350K–$600K based on resident + moonlighting income. Watch-out: Moonlighting W-2 requires 2-year history for qualifying credit. New moonlighting arrangements within past 24 months may not yet count toward qualifying.

Final year residency

Graduating resident with signed attending contract

Comp profile: $65K–$80K current W-2 PLUS signed forward attending contract documenting $250K–$550K future W-2 base plus $25K–$200K sign-on plus $25K–$50K annual loan-repayment-assistance plus RVU schedule. Dominant qualifying method: Physician/Doctor Loan with signed-contract qualifying allowing close 60-90 days pre-start. Common purchase: $600K–$1.4M based on signed forward attending. Watch-out: Pre-start close timing requires careful sequencing relative to residency end date and attending start date. Lease termination and IDR recertification timing also matter.

Final year fellowship

Final-year fellow with signed attending contract

Comp profile: $70K–$85K current W-2 fellow stipend PLUS signed forward attending contract documenting $325K–$700K+ future W-2 base for subspecialty attending positions (orthopedic, neuro, cardiothoracic, GI, cardiology, pulmonary, ENT, urology specialty ranges typical) plus $100K–$500K sign-on plus specialty-tier loan-repayment-assistance plus wRVU schedule. Dominant qualifying method: Physician/Doctor Loan with signed-contract qualifying for jumbo amounts. Common purchase: $850K–$2M+ based on signed forward specialty attending. Watch-out: Higher-specialty attendings often command larger sign-on bonuses with vesting schedules — document the vesting and continuation provisions clearly.

08 · What residents and fellows say

What residents and fellows say about their Stairway mortgage.

Names abbreviated for client privacy. Training details anonymized. Numbers are real.

"Final year of internal medicine residency. Signed attending contract effective July 1 for $285K base plus $65K sign-on plus $35K annual loan repayment for 3 years plus RVU bonus. Current resident W-2 of $68K. Wanted to close on a home in early June so I could move directly from training to attending location without a rental gap. $355K of federal student loans on PAYE with $295/month current payment. The first lender said they needed 6 months of W-2 history at the new attending position before they could qualify, meaning I couldn’t close until January — 6 months of rental in the new city. Jim’s team ran the Physician/Doctor Loan with signed-contract qualifying on the forward attending position, used the documented $295 PAYE payment under B3-6-05, included the multi-year sign-on and loan-repayment continuation. $785K close on a Plantation home with 5% down and no PMI, 18 days before my official attending start date. Moved straight from training city to new house."

Sophia L., MD

Graduating IM resident pre-start close · Plantation

"Final year of cardiology fellowship after 3-year internal medicine residency. Signed interventional cardiology attending contract effective September 1 for $485K base plus $185K sign-on plus $45K annual loan repayment for 3 years plus wRVU bonus. Current fellow W-2 of $79K. $385K of federal student loans on PAYE with $185/month current payment. Wanted to close on a home in late July to coordinate fellowship end (June 30) with attending start (September 1). The first lender wouldn’t qualify me on the signed contract, refused the PAYE payment treatment, and offered $295K maximum. Jim’s team ran the Physician/Doctor Loan with signed-contract qualifying, applied B3-6-05 for the $185 PAYE payment, and structured the file for pre-start close coordinating fellowship end and attending start dates. $1.35M close on a Weston home with 7% down, 35 days before attending start."

Marcus B., MD

Final-year interventional cardiology fellow · Weston

"PGY-3 family medicine resident, married to an established attending pediatrician. My current W-2 $73K, my husband’s attending W-2 $245K. Combined $318K. My $295K of federal student loans on PAYE with $245/month payment, his $180K on PAYE with $1,650/month payment. The first lender ran the 1% rule on both our loan balances ($4,750/month theoretical vs $1,895 actual combined) and offered us $385K. Jim’s team treated us as joint co-borrowers, applied B3-6-05 to BOTH IDR payments separately, used my husband’s 2-year attending W-2 history and my resident W-2, and qualified us on the combined picture. $785K close on a Coral Springs home. Family medicine training was 3 more years for me, but we didn’t need to wait."

Anjali P., MD

PGY-3 resident w/ attending spouse · Coral Springs

09 · Resident & fellow mortgage FAQs

Resident and fellow mortgage questions, answered.

More resident and fellow mortgage resources at Stairway

I’m a PGY-3 about to graduate. Can I qualify for a mortgage on my signed attending contract before I start the job?

Yes. Physician/Doctor Loan signed-contract qualifying allows close up to 60–90 days pre-start using the signed attending contract as documented future income. The contract documents future W-2 base salary, sign-on bonus, loan-repayment-assistance, and RVU schedule. Particularly important for residents finishing training in June with July or August attending start dates — the 60-90 day window allows close in April, May, or June.

I have $385K of federal student loans. Can I still qualify for a mortgage?

Yes — with proper IDR documentation. Under Fannie Mae B3-6-05, the actual monthly payment from your income-driven repayment servicer counts in DTI — not 1% of balance. If you’re on PAYE/SAVE/IBR at resident income, that payment may be $0–$500/month against $385K of debt vs the $3,850 the 1% rule imposes. This swings $500K-$1M of qualifying loan amount for residents.

My residency is at a nonprofit hospital. How does PSLF affect my mortgage planning?

Indirectly but favorably. If your hospital qualifies for PSLF, your IDR payments count toward forgiveness during residency AND count in DTI under B3-6-05. After 120 qualifying payments the remaining balance discharges. For a PGY-1 starting at a nonprofit hospital, the 10-year PSLF clock starts in residency, and the residency years count toward the 120 threshold with $0-$500/month payments — essentially free PSLF qualifying time.

My attending contract has a $150K sign-on bonus. How does that count for qualifying?

Sign-on bonuses with multi-year continuation or retention provisions can qualify as continuing employer compensation under Fannie Mae B3-3.1-01 when documented through the employment contract. Single-payment sign-on bonuses without continuation may be treated as one-time and excluded from monthly qualifying calculation. Multi-year retention bonuses ($25K-$50K annually across 3-5 years) typically qualify as continuing compensation. We review the contract structure to determine treatment.

I’m a PGY-2 with no signed attending contract yet. Can I qualify for a mortgage now?

Yes, on current resident income. Your current PGY-2 W-2 stipend ($65K–$75K typical) qualifies under B3-3.1-01. Combined with B3-6-05 IDR-aware DTI for your medical school student loans, typical qualifying capacity at PGY-2 income runs $250K–$500K. If you’re planning to stay in the city for the duration of residency, that may support a starter home purchase.

My spouse is an attending physician. How does that affect qualifying?

Significantly — your spouse’s established attending W-2 plus your resident W-2 combine as joint co-borrowers, often dramatically increasing qualifying capacity. Two-MD households (resident + attending spouse, or two attending spouses) commonly qualify for $1M-$2M+ mortgages even with significant combined student loan balances when both spouses are on IDR with documented servicer payments. Both files combine for joint qualifying.

I moonlight at urgent care for $25K extra annually. Does that count?

Yes — resident moonlighting W-2 income aggregates with the primary resident W-2 under B3-3.1-01 as continuing employment with 24-month average. Moonlighting requires 2-year history for full qualifying credit. For PGY-3+ residents with 2-year moonlighting track records, this commonly adds $15K-$40K of qualifying income annually.

My specialty is psychiatry. The signing bonuses are high. How does that affect what I can buy?

Psychiatry consistently tops the signing bonus tables along with primary care, family medicine, and rural settings — commonly $50K-$300K signing bonuses plus multi-year loan-repayment-assistance ($25K-$50K annually). For graduating psychiatry residents with signed attending contracts at $275K-$425K plus large sign-on, the Physician/Doctor Loan with signed-contract qualifying commonly supports $700K-$1.2M purchases pre-start.

What documentation do I need for a resident or fellow mortgage?

For current resident/fellow files: current employment letter from the program coordinator confirming ACGME-accredited training status and expected completion date, current W-2 and recent paystubs, 2 years of federal 1040s, IDR servicer statement showing actual monthly payment. For signed-contract qualifying: signed forward attending employment contract showing base salary, RVU schedule, sign-on, loan-repayment provisions, and start date. Plus 60 days of personal bank statements, state medical license documentation, and J-1 waiver paperwork if applicable.

My specialty (neurosurgery) has 7-year residency. Can I still buy a home during training?

Yes — long-duration residencies (neurosurgery 7 years, cardiothoracic 6-7 years, plastic surgery integrated 6 years, vascular 5-7 years) commonly justify early-residency home purchase on current resident income with B3-6-05 IDR-aware DTI. With 5+ remaining years of training in the same city, a starter home purchase often makes financial sense vs continuing to rent for the duration.

Are mortgage rates higher for residents and fellows?

Physician/Doctor Loan rates for residents and fellows are competitive with Conventional Conforming, typically within 0.125–0.375% of standard pricing in exchange for the low-down structure and no PMI. For graduating residents qualifying on signed forward attending contracts at high specialty income, Conventional Jumbo also competes well. We compare programs case-by-case considering down payment availability, loan amount, and expected hold period.

My SAVE plan enrollment has been in limbo with the legal challenges. How does that affect my IDR documentation?

During SAVE plan administrative pauses or legal flux, borrowers may be temporarily in forbearance or transitioned to other IDR plans (PAYE, IBR, REPAYE). For mortgage qualifying, we work with your current servicer to obtain documentation showing your current IDR enrollment status and most recent monthly payment. If you’re in administrative forbearance with $0 payment, that $0 may count under B3-6-05 depending on the underwriter’s interpretation. We coordinate the documentation carefully.

I’m a J-1 visa resident finishing fellowship on a J-1 waiver pathway. Can I qualify?

Yes — J-1 waiver residents and fellows qualify the same as U.S. citizen residents with proper documentation. The waiver provides J-1 status legal foundation for the 3-year underserved area service commitment. We document the waiver approval, the post-waiver attending position contract, and the underserved area service location. The attending position contract supports signed-contract qualifying under Physician/Doctor Loan programs.

I’m finishing residency in June but my attending position starts September. Will pre-start close still work?

Yes — the 60-90 day pre-start window often covers this scenario well. For a September 1 attending start, you can close as early as early June (90 days pre-start) using the signed contract. The gap between June residency end and September attending start gives time for the move, settling in, and onboarding. We coordinate the close timing with the residency end date and attending start date.

My credit score is 720. Is that enough for Physician/Doctor Loan?

Yes — 720+ is comfortably within Physician/Doctor Loan parameters at most specialty lenders. Different lenders have slightly different score thresholds, with some accepting 680+ and others requiring 740+. For best pricing, 740+ generally optimizes. We shop across specialty Physician Loan lenders to find the best terms at your credit profile.

My signed attending contract has an "at-will" clause. Does that affect qualifying?

At-will employment is standard in U.S. physician contracts and does not affect mortgage qualifying. Physician/Doctor Loan signed-contract qualifying does not require a specific employment duration commitment — the signed contract documenting future W-2 income is sufficient under the lender’s forward-employment treatment.

I plan to do fellowship after residency. Should I buy now or wait?

Depends on the geographic relationship. If fellowship is in the same city as residency, current resident-income purchase can make sense. If fellowship is in a different city, buying during residency creates a sell-or-rent decision at fellowship start — coordinating sale at fellowship transition is workable but adds complexity. If fellowship leads to a different long-term attending location, waiting until you have the signed attending contract at the long-term location often optimizes the home purchase timing.

My attending position requires a 3-year service commitment in an underserved area. How does that affect qualifying?

3-year underserved-area service commitments (common for J-1 waiver pathways, National Health Service Corps loan repayment, and state-level rural physician programs) actually strengthen the qualifying case by documenting employment duration certainty. We document the service commitment as part of the underwriting file and qualify on the signed attending contract.

My residency program is military (Army, Navy, Air Force). Does that affect qualifying?

Military residency programs (HPSP scholarship recipients, USUHS graduates) operate slightly differently — you’re a commissioned officer receiving military pay and benefits during training. The military pay structure (basic pay + BAH + BAS) qualifies under standard military W-2 treatment. Post-military attending obligation periods (typically 4 years) document forward employment certainty. VA loan benefits may also apply, providing an alternative to Physician/Doctor Loan with similar low-down structure.

Why do generalist lenders refuse resident files when there’s a signed attending contract?

Two reasons: (1) generalist lenders default to 6 months of post-start W-2 history before they’ll qualify new employment income, missing the entire signed-contract pre-start qualifying mechanic available under Physician/Doctor Loan programs; (2) the $200K-$450K of medical school debt with 1% rule treatment ($2,000-$4,500/month theoretical DTI hit) creates a DTI ratio that disqualifies the file before B3-6-05 IDR documentation can rescue it. Specialty lenders correctly apply signed-contract qualifying and B3-6-05.

I’m a fellow with $415K of student loans from medical school plus residency. Can I still qualify for $1M+?

Yes if you have a signed attending contract with high-specialty income. For final-year fellows with signed forward attending contracts at $400K-$700K (orthopedic, neuro, cardio, GI, cardiology) plus large sign-on bonuses, the Physician/Doctor Loan with signed-contract qualifying commonly supports $1M-$2M+ purchases. The B3-6-05 IDR treatment of the $415K balance with actual servicer-statement payment of $200-$500/month keeps the DTI workable.

When should I start the mortgage conversation relative to a home purchase?

For graduating residents and fellows planning pre-start close: ideally 120-150 days before intended close. Resident and fellow files often take longer than standard files because of signed-contract qualifying coordination, IDR servicer documentation, ACGME training documentation, employer contract review for sign-on and loan-repayment treatment, and possible J-1 waiver paperwork. For PGY-3 residents finishing in June with July attending start, starting the conversation in January or February gives proper runway for a May or June close.

My fellowship contract has a "completion guarantee" but isn’t signed. Does an offer letter count?

Generally no — signed-contract qualifying requires an executed (signed by both parties) employment contract. Offer letters, verbal commitments, or letters of intent typically don’t suffice for Physician/Doctor Loan signed-contract qualifying. The contract documents the future W-2 income with executable terms. We work with the borrower and the future employer to obtain the signed contract before close.

Are there mortgage programs specifically for residents and fellows beyond Physician/Doctor Loan?

Physician/Doctor Loan with Signed-Contract Qualifying is the dominant specialty product for graduating residents and final-year fellows. Beyond that, what matters is finding a broker who understands Physician/Doctor Loan signed-contract qualifying for pre-start close, B3-6-05 IDR documentation for the medical school debt burden, B3-3.1-01 for current resident or fellow W-2 income, multi-source resident + moonlighting W-2 stacking, co-borrower qualifying with attending spouses, and the residency-completion timing coordination that defines this stage.

My partner is also a graduating resident with a signed contract. Can we both qualify on signed contracts?

Yes — two graduating residents with signed forward attending contracts at the same destination location commonly qualify together as co-borrowers. Both signed contracts document future attending W-2 income under Physician/Doctor Loan signed-contract qualifying. Combined attending income from two new attendings ($600K-$1M+ aggregate) often supports $1.5M-$2.5M jumbo purchases at pre-start close timing.

10 · Companion guides & calculators

More on resident and fellow mortgages, signed-contract qualifying, and IDR-aware DTI.

Other medical paths

Loan-program details

Calculators & tools

11 · Sources & further reading

Sources & further reading.

ACGME / NRMP / AAMC & medical training

IRS & tax guidance

Cornell Law — statutory references

Mortgage program & student loan guidelines

BLS & legislation

12 · What "right door first" looks like

Resident or fellow mortgage, structured right.

Final-year internal medicine resident, PGY-3, finishing residency in late June at a community teaching hospital. Signed attending employment contract with a hospital system effective July 1 for $285K base salary plus $65K sign-on bonus paid at start plus $35K annual loan-repayment-assistance for 3 years plus RVU productivity bonus paying $38 per work-RVU above 5,500 threshold. Current resident W-2 of $68K. $355K of federal student loans from medical school on PAYE plan with documented servicer payment of $295/month based on PGY-3 income. Wanted to close on a home in early June to coordinate with attending start date and avoid a 6-month rental gap between residency end and getting settled at the new attending location. The first lender said they needed 6 months of W-2 history at the new attending position before they could qualify, meaning closing wouldn’t be possible until January — 6 months of rental in a new city after just finishing 3 years of residency. Treated the PAYE payment as 1% of balance ($3,550/month theoretical vs $295 actual), pushing the DTI well above acceptable. Refused to count the sign-on or loan-repayment-assistance as continuing employer compensation. Offered $295K maximum loan amount if I waited until January. We pulled the signed employment contract showing the base salary, RVU schedule, $65K sign-on bonus terms, and the 3-year loan-repayment-assistance provision, the IDR servicer statement showing the $295 actual PAYE payment, the ACGME residency completion documentation, and the state medical licensure application. Ran the Physician/Doctor Loan with signed-contract qualifying on the forward attending position, counted the actual $295 IDR payment under Fannie Mae B3-6-05, treated the 3-year loan-repayment-assistance as continuing employer compensation, and structured the file for 18-day pre-start close. Approved at $785K with 5% down (no PMI under physician loan structure) for a Plantation home. Closed on June 13, 18 days before the official attending start date. Moved straight from training city to the new house without a rental gap. The signed contract was real, the IDR payment was documented, the loan-repayment was contracted — the first lender just didn’t know how to read a resident file with signed-contract forward qualifying.

18-day pre-start close · Plantation, FL

Talk to a resident and fellow mortgage specialist

Get a resident or fellow mortgage from a lender who reads signed forward attending contracts, training-period IDR, PSLF eligibility, and pre-start close timing as one file.

No application. No credit pull. A 20-minute conversation where we look at your current resident or fellow W-2 stipend, your signed forward attending contract if applicable showing base salary plus RVU schedule plus sign-on plus loan-repayment terms, your IDR servicer statement showing actual monthly payment, your ACGME training documentation, any moonlighting W-2 or J-1 waiver paperwork, and any co-borrower attending spouse income — then we tell you whether Physician/Doctor Loan with signed-contract qualifying, Physician Loan with current income, or Conventional Conforming fits and roughly what the numbers look like. If we’re not the right shop, we’ll tell you that too.

Talk to Our Team Back to the medical professionals hub

Jim Blackburn NMLS #1072866 · Stairway Mortgage

Key facts every medical resident and fellow should know before applying for a mortgage.

Resident and fellow mortgage solutions for every training stage.

Early-stage resident (PGY-1 — PGY-2)

Mid-residency (PGY-3 — PGY-4)

Graduating resident (final year)

Subspecialty fellow (PGY-4 through PGY-7+)

Final-year fellow with signed attending contract

How we calculate qualifying income for your resident or fellow mortgage.

Method 1 — Signed forward attending contract qualifying (the graduating-resident default)

Method 2 — Current resident or fellow W-2 + IDR-aware DTI (the early-stage path)

Method 3 — Resident W-2 + moonlighting + co-borrower stacking

Method 4 — FHA conventional alternative for tight-cash residents

The income most lenders refuse to count on a resident or fellow file.

Signed forward attending contract qualifying (60-90 days pre-start)

Federal student loan IDR payment at $0-$500/month (B3-6-05)

PSLF qualifying payment accrual during nonprofit hospital residency

Forward attending sign-on, loan-repayment, and relocation packages

Resident moonlighting W-2 supplementary income

Residency-completion timing and pre-start close coordination

Which loan program fits your resident or fellow mortgage situation.

Physician/Doctor Loan w/ Signed-Contract Qualifying (primary)

Physician/Doctor Loan w/ Current Income

Conventional Conforming (IDR-aware)

Conventional Jumbo (specialty attending)

Multi-Source W-2 (resident + moonlighting)

Co-Borrower with Attending Spouse

FHA Conventional Alternative

The resident and fellow mortgage in context: 6 forces shaping how trainees qualify.

Force 1 — Residency duration variability across specialties

Force 2 — Match Day and the June/July relocation timing

Force 3 — ACGME accreditation and training documentation

Force 4 — Federal student loan IDR and SAVE plan regulatory dynamics

Force 5 — PSLF for nonprofit hospital residency

Force 6 — J-1 visa international medical graduate considerations

Resident and fellow mortgage by training stage.

Early-stage resident

Mid-residency resident

Graduating resident with signed attending contract

Final-year fellow with signed attending contract

What residents and fellows say about their Stairway mortgage.

Resident and fellow mortgage questions, answered.

More on resident and fellow mortgages, signed-contract qualifying, and IDR-aware DTI.

Other medical paths

Loan-program details

Calculators & tools

Sources & further reading.

ACGME / NRMP / AAMC & medical training

IRS & tax guidance

Cornell Law — statutory references

Mortgage program & student loan guidelines

BLS & legislation

Resident or fellow mortgage, structured right.

Get a resident or fellow mortgage from a lender who reads signed forward attending contracts, training-period IDR, PSLF eligibility, and pre-start close timing as one file.

Download The Stairway Roadmap.