3 Outdated Mortgage Rules That Don’t Apply to Physicians

TL;DR:
Physicians often receive generic mortgage advice that doesn’t reflect their unique financial reality. From waiting to save 20% down to avoiding homeownership during training, many outdated rules don’t apply to modern doctors. This blog breaks down three common mortgage myths and explains why physicians should follow a different playbook.

The Problem With Traditional Mortgage Advice

Doctors are often high earners—but with delayed income, massive student debt, and a non-linear career path.
And yet, they’re given the same mortgage advice as the average buyer. This is a massive failure!

The truth? What works for most borrowers can be a bad fit for physicians.
Especially if you’re early in your career, moving frequently, or buying with a unique income structure.

Let’s unpack three outdated mortgage rules—and what doctors should do instead.

1. “You Need to Put 20% Down to Avoid PMI”

This rule is ingrained in most first-time buyers—and it’s true for conventional loans.
But for physicians, this rule doesn’t apply. And it is fundamentally just bad advice.  Sure, if you have a million dollars saved up. No student loan debt, and the kids’ college funds are taken care of.  But that’s not typically who we are talking about here.  So use the physician mortgage as a great tool that it can be. 

Why it’s outdated for doctors:
Physician mortgage loans allow:

• 0–5% down
  
• No private mortgage insurance (PMI)
  
• No requirement to hit 20% equity upfront

This gives doctors flexibility to buy earlier in their career, avoid draining savings, and still avoid PMI fees.

Want to see how physician loans compare? What are the Best Physician Mortgage Loans? offers a curated list of top programs—many with no down payment or PMI required.

2. “Don’t Buy Until You’ve Paid Off Your Student Loans”

This advice assumes that student loans are always a disqualifying factor for mortgage approval.
But physician loans are built to work with student debt, not against it. You delay building wealth through real estate as you chuck away that mountain of debt.   People who advocate for you to do that probably paid 1/8th the price for college than you did…. Don’t fall for that old school outlook.

Most doctor-specific loan programs:

• Exclude student loans in deferment or IDR from DTI calculations
  
• Don’t penalize applicants with six-figure balances
  
• Recognize your future earning potential, not just current pay

So if you’re waiting to be debt-free before buying, you may be waiting far longer than necessary.
Learn how student loan treatment varies in How Student Loan Changes Affect Your Credit Score, especially for physicians with federal repayment plans.

3. “Renting Is Safer While You’re in Residency or Fellowship”

Right,  because how many doctors made it this far who can afford to continue to sleep in a small, run down, 1 bedroom apartment?  Not many, most have started families or ready to take that leap.  If you want that “sleeping on someone’s couch” life style… sure, rent. But chances are you are at the stage of your life where it’s time for your own space. 

This one sounds logical:

• Your job is temporary
  
• You’re on a resident salary
  
• You might move in a few years

But renting isn’t always cheaper—or smarter.

Physician mortgage programs allow residents and fellows to:

• Buy using future income (employment contract)
  
• Avoid PMI, even with no down payment
  
• Secure long-term equity in high-rent markets

For doctors training in expensive metro areas, buying a modest home or condo can actually cost less than renting—and result in a sale or rental income down the road.

See Should You Buy or Rent This Summer as a Resident Physician? for a breakdown of pros and cons in real-world examples.

Why These Rules Persist (and Who They’re Actually For)

Most mortgage rules were written for:

• Buyers with average income
  
• Predictable employment
  
• Minimal student debt
  
• 9–5 schedules

That’s not you.
Your career is high-income but delayed, flexible but demanding, and structured differently from most professions.

Physician mortgage loans exist to address that reality.
But many doctors miss the opportunity because they’re applying outdated, irrelevant rules.

External Insight: The Rise of Specialized Mortgages

According to a 2024 report by National Mortgage News, banks are expanding physician loan programs to meet demand from early-career doctors who want to buy sooner and more affordably.

The report highlights that lenders are recognizing:

• Low default rates among medical professionals
  
• High long-term earning potential
  
• Strong credit behavior—even with student debt

That’s exactly why doctor loans break the conventional mold.

Final Thoughts

Following outdated mortgage advice can delay homeownership and cost doctors thousands.
Instead of defaulting to rules that don’t apply, physicians should work with lenders and strategies built for their unique journey.

Don’t wait for 20% down.
Don’t fear your student loans.
And don’t assume renting is always the “safe” option.

You’ve got options—and doctor-specific tools to back them up.

Want a mortgage strategy tailored to your medical career—not someone else’s 9–5?
Connect with a physician mortgage expert and build a plan that fits your path.