Most of the money physicians lose on a mortgage is lost before they ever look at a rate. It goes in assumptions made early, questions not asked, and timelines nobody checked.
Here are the ones we see most, roughly in the order they happen.
1. Shopping the Rate Before Shopping the Rules
The rate is the last thing that matters and the first thing everyone asks about. Whether a lender will count your student loans at your real payment or at 1% of the balance moves your approval by thousands of dollars a month. A quarter point moves it by a hundred.
Ask how they count student loans first. Ask about the rate fourth.
2. Assuming Every Physician Loan Takes Your Degree
Eligible degree lists vary far more than people expect. Some programs stop at MD and DO. Others include dentists, podiatrists, optometrists, veterinarians, pharmacists and nurse anesthetists.
If you are not an MD or DO, do not assume. Check the list before you get attached to a lender.
3. Believing There Is a Ten Year Rule Everywhere
Many programs limit eligibility to physicians within a certain number of years of finishing training. Many do not. Being twelve years out is a decline at some lenders and a non-issue at others.
If you have been told you no longer qualify for physician financing, that was one lender’s rule, not a law.
4. Treating the Approval Amount as a Budget
A lender’s maximum is a legal and statistical limit. It is not advice about what you should spend, and it does not know about your daycare costs, your retirement savings or your intention to have a life.
Physician programs approve larger numbers than conventional ones. That is the benefit and the trap. We work through the difference in approved versus comfortable.
5. Taking Zero Down Because It Is Offered
Zero down is a tool for people whose cash is genuinely the constraint. It is not free. You start with no equity, which means a modest dip in prices or a sale within a few years can leave you writing a check to get out.
Note too that on several programs the debt-to-income ceiling drops when you put nothing down. Five percent can buy you five points of qualifying room. Detail in what the 0% tier actually covers.
6. Not Getting the Student Loan Payment in Writing
A documented monthly payment above $0 unlocks a friendlier rule in nearly every mortgage program. A blank or $0 on your credit report triggers the balance-percentage rules instead.
Get a statement from your servicer showing the actual payment. It is a ten minute task that can change your approval by a thousand dollars a month. Our guide to how lenders count student loans shows what each program does with the number.
7. Starting the License Application Late
If your employment contract is contingent on a state license you do not have yet, some lenders will not use that income until the license is issued. Licensing boards move at their own pace.
Start it the day you are allowed to. It is the single most common reason a physician closing slips.
8. Forgetting the Gap Between Closing and Your First Paycheck
Closing three months before your job starts means three mortgage payments before any attending income arrives, during the same months you are paying to move. Some lenders want you to have cash reserves set aside to cover it, some do not, but your bank account does not care which.
9. Opening Credit During the Process
Furniture financing, a new car, a store card at the appliance shop. Any of these can change your debt-to-income ratio or your score between approval and closing, and lenders re-check.
Buy the couch after you have the keys.
10. Moving Money Around Without a Trail
Underwriters need to see where cash came from. Transfers between your own accounts, cash deposits and family gifts all generate questions, and an unexplained deposit can hold up a closing.
If family is helping, get the money into your account early and keep the paper trail.
11. Comparing Total Closing Costs Instead of Lender Fees
Two Loan Estimates can differ by thousands purely because of when your property taxes and insurance are collected and set aside, which is your own money and not a charge. The number that reflects what a lender is actually charging you is section A on page 2.
Compare section A. Ignore the bottom line when you are ranking lenders. More in closing costs and cash to close.
12. Buying Without an Honest Answer on How Long You Will Stay
This is the expensive one. Buying and selling a house costs real money on both ends. Own it for two years and those costs are spread thin. Own it for fourteen months because fellowship moved you, and they are not.
Before anything else, answer honestly how long you expect to be in that city. If the answer is under three years, read the break even test before you go further.
The Short Version
Ask about student loan treatment first. Get your real payment documented. Start your license early. Decide your own budget rather than accepting the maximum. And be honest about your timeline.
If you want the lender question answered without calling five banks, tell us your degree, your training stage, your state and your numbers, and we will match you with the one whose rules fit. It takes about two minutes and costs you nothing.
Last verified September 10, 2026.