The amount a lender will approve you for and the amount you should actually borrow are two different numbers, and the gap is usually large. A physician program will often approve you at a 50% debt-to-income ratio with nothing down. A comfortable housing payment for most people sits closer to 25% to 28% of gross income.
This page gives you both numbers and shows you how to find the space in between, which is where you actually want to buy.
Start With What Approval Really Measures
Approval measures whether the bank expects to get paid back. That is a lower bar than whether your life will be pleasant.
Physician programs commonly publish a maximum DTI of 50%. That means half your gross monthly income can go to debt payments and the loan still clears. It clears because physicians rarely default, not because 50% is a comfortable way to live.
The number worth anchoring on is your housing payment as a share of gross income. Under 28% is comfortable for most households. Between 28% and 33% is workable if the rest of your budget is clean. Above that, something else in your life gets squeezed.
What a Payment Looks Like
Rates move every week, so the table below is an illustration, not a quote. It assumes a 6.5% rate on a 30-year term, and shows principal and interest only. Swap in whatever rate you are actually quoted using the physician mortgage payment calculator.
| Loan amount | Monthly principal and interest |
|---|---|
| $400,000 | $2,528 |
| $500,000 | $3,160 |
| $600,000 | $3,792 |
| $750,000 | $4,741 |
| $1,000,000 | $6,321 |
Property taxes and homeowners insurance are on top of every one of those figures, and in some states they add 25% or more to the payment. Ask your agent what taxes actually run in the neighborhoods you are looking at, because the difference between counties can be thousands a year.
Working It Backward From Your Income
This is the calculation worth doing before you look at a single listing. Take your gross annual salary, multiply by 0.28, and divide by 12. That is a comfortable total housing payment including taxes and insurance.
| Gross salary | 28% housing payment | Roughly supports a loan around |
|---|---|---|
| $65,000 (resident) | $1,517 | $180,000 |
| $250,000 (attending) | $5,833 | $700,000 |
| $400,000 (specialist) | $9,333 | $1,120,000 |
The loan figures assume roughly 20% of the payment goes to taxes and insurance, which is a rough national average and will be wrong for your specific county. Use it as a starting point, then adjust with real local numbers.
For context, the median existing home in the United States sold for $434,100 in July 2026 (NAR, August 11, 2026).
The Resident Situation Is Genuinely Different
If you are a resident earning $65,000, the honest math says a modest house. A physician loan may approve you for much more, particularly if your student loans are excluded from DTI, but approval does not create income.
There is a fair counterargument, and it is worth weighing rather than dismissing. Your income is about to multiply. Buying at the top of a resident budget can look reasonable if your attending salary starts in eighteen months and you are staying in the same city.
The risk is that residency ends and you match somewhere else, and then you own a house you cannot afford to sell without bringing cash. That tradeoff is the whole subject of buying a house during residency.
The salary figures by training year, and what they realistically buy, are in physician mortgage loans for residents and fellows.
What Your Student Loans Do to the Number
This is where physician loans change the arithmetic, and it is worth seeing it directly.
On median medical school debt of $215,000, a lender using the FHA or Freddie Mac fallback counts about $1,075 a month against you. A lender using Fannie Mae’s deferment rule counts about $2,150. A physician program that excludes deferred student debt counts $0 (AAMC, October 2025).
Removing $2,150 from your monthly debt column at a 43% DTI target frees up roughly $5,000 a month of gross income capacity, which is several hundred thousand dollars of house. This single rule moves the answer more than your interest rate does. See how student loans are counted.
The Costs That Do Not Show Up in the Payment
People budget the mortgage and forget the rest. Plan for:
- Closing costs of 2% to 5% of the purchase price (Freddie Mac, February 2026)
- Maintenance, commonly estimated at 1% of the home value per year
- HOA dues, if applicable, which are not always disclosed early
- Furnishing an empty house, which is very real when you are coming from an apartment
- Moving costs, especially a cross-country move for residency or a new position
- Cash reserves, the money your lender requires you to keep in the bank after closing
A Sanity Check Worth Running
Before you commit, try this for two or three months. Take the difference between your current rent and the full projected housing payment, and move it into savings automatically on the first of the month.
If that is easy, the number works. If it is uncomfortable, you have learned something important at no cost, and you can adjust the price you are shopping at instead of finding out after closing.
Where to Go From Here
Once you know the payment you want, the next question is which lender gets you there. That depends on your degree, your training stage, your state and how they count your student loans.
Tell us your situation and we will match you with a lender whose published terms fit. About two minutes, no cost to you.
Related: how physician mortgage loans work, what it takes to qualify, and what the zero down tier really covers.
Last verified September 9, 2026. Rates change weekly. We recheck this page monthly.
If this is your first purchase, the first-time buyer guide for physicians walks the whole process in order, and the mistakes list covers what tends to go wrong.