The Spokane mortgage guides
Physician & Medical Professional Loans
Updated: October 2026
Physician Loans in Spokane, WA.100% Financing, No PMI
Signed contract, six figures of student debt, nothing saved for a down payment. Most lenders call that a problem file. This loan was built for it.
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Physician loans in Spokane let doctors, dentists, veterinarians, PAs, NPs, and CRNAs buy a primary residence with up to 100% financing and no mortgage insurance, qualifying on a signed employment contract before the first paycheck lands. We offer it in-house. Here's what it does and where its limits are.
Why the standard loan fails a new doctor
Picture the file. A third-year resident at Providence Sacred Heart signs an attending contract starting in August. The income is excellent on paper and zero in the bank. Student loans sit in forbearance at $280,000. Savings went to boards, the match, and two moves. A conventional underwriter sees a borrower with no verifiable salary yet, a phantom student loan payment of $2,800 a month at 1% of balance, and a 5% down payment that doesn't exist. Declined, or approved for a condo nobody wants.
The physician loan was designed around that profile. The contract counts as income, there's no mortgage insurance on the payment, and for borrowers still in training the student loans can stay out of the ratio. It comes as a 30-year fixed or an adjustable with a 5-, 7-, or 10-year initial fixed period, on a primary residence only.
The financing tiers, in real numbers
Leverage is set by loan amount and credit score, and it's more generous than anything a conventional loan offers:
- Up to $1,000,000: 100% financing with a 700 credit score.
- Up to $1,500,000: 100% financing with a 720 credit score.
- Up to $2,000,000: 95% financing with a 700 credit score.
No mortgage insurance at any tier. Minimum loan is $100,000 on the fixed-rate version and $200,000 on the ARMs. Debt-to-income can run to 50%, tightening to 45% when you're borrowing more than 95% of the price. A seller can contribute up to 3% toward closing costs and prepaids.
At the Spokane end of the market, that first tier covers almost everything a new attending would look at: South Hill, Kendall Yards, the Five Mile and Mead neighborhoods north of town, Liberty Lake and Spokane Valley near MultiCare Valley Hospital, or Coeur d'Alene and Hayden for anyone joining Kootenai Health. The second and third tiers are where this program overlaps with jumbo financing, and the physician version wins there on down payment every time.
Who's eligible
Licensed or soon-to-be-licensed medical professionals:
- Physicians: MD, DO (psychiatry included), DPM
- Dental: DDS, DMD
- Eye: ophthalmology, OD
- Pharmacy: PharmD
- Veterinary: DVM
- Advanced practice: physician assistant, nurse practitioner, CRNA
Residents, fellows, and practicing attendings all qualify. Self-employed practitioners qualify on two years of personal and business returns. Permanent residents are eligible with 24 months of U.S. employment; non-permanent residents with a current visa can qualify with some additional restrictions, including a 95% financing cap. Every borrower on the loan has to occupy the home, so a parent co-signing from across the country doesn't work here.
Qualifying on a contract you haven't started
This is the feature that matters most for anyone finishing training. A fully executed employment contract or offer letter, signed by both sides, counts as qualifying income when it states your position, a start date no more than 150 days after closing, and compensation covering at least 12 months. The only contingencies the contract can carry are your receipt of a medical license and the routine administrative items: background check, drug screen, fingerprinting. Anything else outstanding, like credentialing that hasn't cleared, needs to be resolved first.
Contract and 1099 physicians get a similar door with a shorter runway: an executed contract with a guaranteed minimum salary or hourly rate and stated hours, a start within 60 days of closing, and last year's return if you filed on 1099 income.
Reserves are the catch people miss. The program wants two months of the full payment (principal, interest, taxes, insurance, and any HOA dues) in the bank after closing, plus enough to cover every month between closing and your start date. Gift funds are allowed for reserves. Borrowed funds are not. Buy in May with an August start and you're documenting roughly five months of payments; the June 1 closer with a June 15 start needs far less.
The student loan rule, as actually written
Most physician-loan marketing says "student loans excluded." The real rule is narrower, and you should know it before you plan around it.
Your student loans come out of the debt-to-income calculation when all three are true: the loans are deferred, in forbearance, or reporting $0 due; you're currently in residency or fellowship; and you're qualifying on the income you earn in that training program. A PGY-3 at Providence or Deaconess buying on resident pay fits cleanly.
Qualify on a future-start attending contract instead and the loans count. The payment used is whatever the credit report shows, or if that's $0, the payment on your loan documents, or for deferred and forborne loans either 1% of the balance or a fully amortizing payment from your repayment terms. For a new attending on a $300,000 contract, a $2,500 student loan payment is usually survivable inside a 50% ratio. For a resident on a $70,000 salary, it isn't, which is exactly why the exclusion exists for them. I run both paths and tell you which one closes.
What this loan won't do
It's a primary-residence loan for a purchase or a rate-and-term refinance. It won't do cash-out, second homes, rentals, 2-4 unit properties, or manufactured homes. Eligible property types are single-family homes, warrantable condos, PUDs, co-ops, and modular homes on fewer than 40 acres. You can't stack down payment assistance or a second mortgage behind it, and temporary rate buydowns aren't allowed. Every file gets a full appraisal.
If you're a physician buying a duplex to house-hack, or carrying 20% down and a clean conventional file, this isn't your loan, and I'll say so. The multifamily guide and the conventional guide cover those paths.
How I run the numbers with you
Send me the contract or offer letter, your most recent pay stubs if you're in training, the student loan servicer statements, and a rough idea of what you'd want to spend. I'll build three versions: the physician loan, a conventional loan with whatever down payment you actually have, and VA if you've served. You'll see the real monthly payment on each, with the student loan treatment spelled out, before you tour a single house. Pre-approval usually comes within 24 hours of receiving your documents.
The files that use this program tend to look like this: a WSU Elson S. Floyd grad matched into a Spokane residency, a Deaconess hospitalist moving to Coeur d'Alene for the lake, a dentist buying a first home in Spokane Valley on a contract that starts in October. Call, text, or start above. Bring the contract.
On the record
Frequently asked questions.
Who qualifies for a physician loan in Spokane?
Licensed medical professionals buying a primary residence: MDs and DOs (including psychiatrists), podiatrists, dentists (DDS and DMD), ophthalmologists, optometrists, pharmacists (PharmD), veterinarians, physician assistants, nurse practitioners, and CRNAs. Residents and fellows qualify on their training income. Attendings qualify on a signed employment contract even before the first paycheck. Minimum credit score is 700, and every borrower on the loan has to live in the home.
Can I really get 100% financing with no PMI?
Yes, with limits. Current guidelines allow 100% financing up to $1,000,000 with a 700 credit score and up to $1,500,000 with a 720. From there to $2,000,000 the cap is 95%. No mortgage insurance at any of those tiers, which is the part that separates this from a conventional loan with 3% or 5% down, where PMI runs until you reach 20% equity. You'll still need closing costs and two months of payments in reserve, though gift funds can cover the reserves.
How are student loans treated on a physician mortgage?
This is where the generic internet version gets it wrong, so here's the actual rule. Your student loans are left out of your debt-to-income ratio only when they're deferred, in forbearance, or reporting a $0 payment AND you're currently in residency or fellowship AND you're qualifying on that training income. If you're qualifying on a future-start attending contract, the student loans count: the payment on your credit report, or if it shows $0, either 1% of the balance or a fully amortizing payment from your loan documents. For a lot of new attendings the contract income is large enough to absorb that anyway. I run it both ways.
Can I close before my job starts?
Yes. A fully signed employment contract or offer letter works as qualifying income as long as your start date is within 150 days of closing and the contract covers at least 12 months of salary. The only contingencies allowed are your medical license and the routine stuff: background check, drug screen, fingerprinting. You'll need reserves to cover the mortgage payment for each month between closing and your first day, on top of the standard two months. 1099 and contractor physicians can qualify on an executed contract too, with a guaranteed minimum salary or hourly rate and a start date within 60 days.
What's the debt-to-income limit?
50% on most files. Above 95% financing the cap tightens to 45%. Those are generous compared with a standard conventional loan, and they're what make a $400,000 purchase workable for a PGY-2 earning resident pay while carrying six figures of deferred student debt, or a new attending whose contract income starts in ninety days.
What can't this loan do?
It's a primary-residence purchase or rate-and-term refinance loan, period. No cash-out refinancing, no second homes, no investment property, and no 2-4 unit buildings. The home has to be a single-family house, warrantable condo, PUD, co-op, or modular home; manufactured homes are out. Down payment assistance and second mortgages can't be layered on, temporary buydowns aren't allowed, and a non-occupying co-borrower (a parent co-signing from out of town) isn't permitted. If any of those describe your situation, there's usually a different program that fits, and I'll tell you which.
Is a physician loan always the right choice for a doctor?
No. If you have 20% down, a conventional loan has no PMI either and often prices better. If you're a veteran, a VA loan is also 100% financing with no monthly mortgage insurance and should be compared head to head. The physician loan wins when the down payment isn't there yet, when the student loan math kills a conventional approval, or when you need to close on a contract before the paychecks start. I price all three and show you the actual monthly difference instead of defaulting to the specialty product.
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