Physician Mortgage Massachusetts: What Attending Physicians Should Know Before They Decide
Most of the physicians I talk to have already heard of the physician loan. They know it exists, they know it doesn’t require Private Mortgage Insurance (PMI), and they’re trying to figure out whether it’s actually the right move for their situation or whether a conventional mortgage would serve them better.
That’s exactly the right question to be asking. And the honest answer depends on a few things that most lenders won’t walk you through carefully. Let’s do that now.
What the Physician Loan Actually Is
The medical professional loan is a specialized mortgage program we offer through our lender network at GoldCoast Mortgage. For attending physicians, here’s what matters:
- No PMI, even with less than 20% down
- Up to 100% financing with a 720+ FICO score (loans up to $1,500,000)
- Up to 95% financing with a 680+ FICO
- Loan amounts up to $2,000,000
- 30-year fixed or ARM options
- Primary residence purchase or rate-and-term refinance only
As an attending, you’re likely past the student loan deferment and future-income-qualifying scenarios that make this program essential for residents. The question for you is simpler and more financial: does the no-PMI benefit outweigh the rate premium? The answer isn’t always yes.
Who Qualifies
The program requires a doctoral-level degree in an eligible field. Qualifying designations include MD, DO, DDS, DMD, PharmD, DVM, VMD, DPM, and CRNA (with DNAP or DNP). One important note: chiropractors are not eligible under this program. GoldCoast has an article going over this mortgage for dentists and pharmacists.
At least one borrower whose income is being used to qualify must hold one of these designations and be in active practice. Non-occupant co-borrowers are allowed, provided their income doesn’t exceed 50% of total qualifying income.
The Rate Tradeoff: The Honest Version
This is where most physician loan content goes soft. I’m going to be direct about it.
The physician loan carries a higher interest rate than a conventional mortgage. That rate premium is permanent unless you refinance. Conventional PMI is temporary. That distinction matters more than most people realize.
Here’s how it works: because the program doesn’t require PMI, the lender builds a rate premium into the loan to compensate for the risk of a low-down-payment loan without insurance. This is structurally identical to what’s called Lender-Paid Mortgage Insurance (LPMI) on a conventional loan. You pay a higher rate instead of a monthly PMI fee.
On a conventional loan, PMI drops off once you reach 20% equity. You can also request cancellation once you hit that threshold. The physician loan’s rate premium never drops off on its own. It stays for the life of the loan unless you refinance.
I’ve had attending physicians come to me a few years after closing on a physician loan, carrying a rate that was meaningfully above the conventional market. In each case we ran the refinance math, and the savings were significant. The physician loan made sense at the time, but they needed to know going in that refinancing to conventional was likely part of the plan.
When the Physician Loan Wins
There are real scenarios where it’s the right call, even for an established attending.
- You want to preserve capital rather than tie it up in a large down payment. Many physicians prefer to keep liquidity for investing, paying down student loans, or funding a practice. Putting 5% down instead of 20% on a $900,000 home frees up $135,000. That’s meaningful capital.
- You’re buying at a price point where PMI on a conventional loan would be substantial, and you expect to hit 20% equity relatively quickly through appreciation and principal paydown on the North Shore market.
- You’re a 1099 contractor or have variable income. This program follows Fannie Mae guidelines for self-employed borrowers, which means one year of personal and business tax returns can suffice rather than the standard two. If you’re a physician with complex income, that’s a real advantage. Our self-employed mortgage guide covers this in detail.
- Your FICO score is strong (720+) and you want 0% down on a purchase up to $1,500,000. That combination simply isn’t available on a conventional loan.
When Conventional Is the Better Choice
- You have 20% to put down. A 20% down conventional loan has no PMI, a lower rate than the physician loan, and no need to refinance later. It’s almost always the better long-term choice at that down payment level.
- You have 10% down and a strong rate environment. At 10% down, conventional PMI is modest and falls off in a few years. The physician loan’s permanent rate premium can cost more over a typical 7–10 year hold period.
- You’re planning to stay in the home long-term and don’t want the friction of a future refinance. Conventional locks in a lower rate from day one.
The White Coat Investor’s comparison of physician vs. conventional loans is worth reading alongside this. They run the long-term math in detail. The short version: the higher the down payment and the longer the hold, the more conventional wins. The lower the down payment and the shorter the hold, the more the physician loan’s advantages matter.
The Numbers Side by Side
Here’s how the two options compare on a $750,000 purchase, a realistic price for a single-family home in towns like Beverly, Salem, or Gloucester on the North Shore right now. Current rates as of March 2026:
| Line Item | Physician Loan (5% down) | Conventional (5% down) | Conventional (20% down) |
|---|---|---|---|
| Down payment | $37,500 | $37,500 | $150,000 |
| Loan amount | $712,500 | $712,500 | $600,000 |
| Rate | ~6.875% | ~6.375% | ~6.375% |
| Principal & interest | ~$4,681/mo | ~$4,446/mo | ~$3,743/mo |
| PMI | None | ~$250–$300/mo | None |
| Taxes & insurance (est.) | ~$1,200/mo | ~$1,200/mo | ~$1,200/mo |
| Est. total monthly cost | ~$5,881 | ~$5,896–$5,946 | ~$4,943 |
| PMI goes away? | N/A | Yes, at 20% equity | N/A |
At 5% down, physician loan and conventional are nearly identical month-to-month today. The rate premium roughly offsets the PMI. But as rates fall or equity builds and the conventional PMI drops, the conventional loan improves. The physician loan doesn’t.
At 20% down conventional, the gap is nearly $1,000/month. If you have the capital, that math is hard to ignore.
What the Application Looks Like for Attending Physicians
Because this program is manually underwritten, the documentation requirements are thorough. Here’s what to have ready:
- Proof of doctoral degree and active practice (medical license, hospital privileges letter, or employment contract)
- Two months of bank statements
- Most recent two years of W-2s and federal tax returns (one year if 1099/self-employed with at least 12 months of self-employment reported)
- YTD pay stub or P&L if self-employed and applying after April 30
- 680 minimum FICO; 720+ for 100% financing
- No 30-day late payments on housing in the past 12 months
- Four years of seasoning required after any bankruptcy, foreclosure, or short sale
One note on student loans: unlike the residents program, attending physicians who are past deferment will have their student loan payments counted in the DTI calculation. The specific method depends on your repayment status, something we work through with you before any application starts.
My Take for Physicians on the North Shore
I’ve been working with physicians and high-income professionals in this market for a long time. The physician loan is a genuinely useful program, but it’s not automatically the right answer just because you’re a doctor. Whether to use it depends on how much you’re putting down, how long you plan to stay, and what you want to do with the capital you’d otherwise deploy as a down payment.
The conversation I want to have with you is simple: here are your actual numbers under both scenarios, here’s what each costs over your likely hold period, and here’s the honest recommendation. Sometimes that’s the physician loan. Sometimes it’s conventional. It depends on you specifically. To get more information about what is right for you, read our article about what you need to know about the Physician’s Loan in Massachusetts as a new resident.
As an independent mortgage broker, we’re not tied to any single product. We shop lenders on your behalf and give you a straight answer. That’s the whole job.
Let’s Run Your Numbers
Whether you’re leaning toward the physician loan or a conventional mortgage, the right answer comes from comparing them side by side with your actual income, down payment, and the home you’re looking at. Give us a call. No forms, no pressure, just a conversation.
GoldCoast Mortgage is an independent broker based in Beverly, Massachusetts, serving buyers across the North Shore since 1998.
GoldCoast Mortgage | 100 Cummings Center, Suite 544H, Beverly, MA 01915 | NMLS #4931
Frequently Asked Questions
Is the physician loan always better than a conventional mortgage for doctors?
No. The physician loan carries a higher interest rate than a conventional mortgage, the tradeoff for no PMI. If you have 20% down, conventional is almost always the better long-term choice. At lower down payments, the two options are often close month-to-month, but conventional PMI eventually drops while the physician loan’s rate premium does not. We run the full comparison for your specific scenario.
Can I use the physician loan if I’m a 1099 contractor or practice owner?
Yes, with specific requirements. You’ll need a minimum of one year of self-employment documented on tax returns, an executed employment or contractor agreement with a guaranteed salary or hourly rate, and a letter confirming no out-of-pocket practice expenses. If your prior year returns show business expenses, you’ll need to qualify under standard self-employed guidelines instead. Our self-employed mortgage guide covers this in more detail.
What’s the maximum loan amount?
Up to $2,000,000. For loans between $1,500,001 and $2,000,000, you’ll need a 720 FICO and at least a small down payment. The 100% financing option tops out at $1,500,000. Minimum reserves of 3–6 months also apply at higher loan amounts.
Do my student loans count in the debt-to-income calculation?
Yes, for attending physicians who are past the residency deferment window. The specific calculation method depends on your repayment status, whether you’re on a standard plan, income-driven repayment, or have a balance showing on your credit report. We work this out before we start the application.
Can I refinance a physician loan into a conventional mortgage later?
Yes, and many physicians do exactly that. Taking the physician loan now to preserve capital or minimize the down payment, then refinancing to conventional once you’ve built equity and established a stronger income track record, is a common and reasonable strategy. We can help you think through the timing.
What properties are eligible?
Primary residence only: purchase or rate-and-term refinance. Single-unit properties. No investment properties, no second homes, no construction-to-permanent financing. Properties up to 10 acres are eligible on a 30-year fixed. If you’re looking at a condo, warrantability is a separate question worth checking early. Our condo warrantability guide covers what to look for.
Does GoldCoast Mortgage lend directly?
No. We’re an independent mortgage broker, not a lender. We shop multiple lenders on your behalf, including those offering this medical professional program, and find the fit that makes the most sense for your situation. We don’t have our own loan products to push.