New Contract, New Job: How Physician Income Affects Buying

New year, new role, new income… and maybe a new house.

If you’re a physician changing jobs—or a resident about to become an attending—you’re not just upgrading your title. You’re also changing how underwriters look at your income, your risk, and your ability to qualify for a mortgage.

On paper, it feels simple: I’m making more money, so buying a home should be easier.
In reality, contract details, start dates, and how you’re paid (W2 vs 1099) can make the difference between a smooth approval and a frustrating “not yet.”

This article breaks down how a new physician contract affects home financing, with a focus on:

• Using future-dated contracts to qualify before you start
  
  

• Why 1099 physician income can be a problem without a 2-year history
  
  

• How short-term guarantees in dental and medical contracts can create underwriting headaches 

The goal: help you time your job change and your home purchase so your mortgage works with your contract—not against it.

The Big Picture: Why Lenders Care About Job Changes So Much

From a physician’s point of view, a new role often looks like a clear upgrade:

• Higher base salary
  
  

• Better call schedule
  
  

• Partnership track
  
  

• Relocation to a more desirable city or health system 

From a lender’s point of view, though, any job change = new risk.

Underwriters aren’t evaluating whether you’ll be a great surgeon or internist. They’re asking:

• Is this income stable and likely to continue?
  
  

• Is the structure of the contract consistent and predictable?
  
  

• Can we document everything in a way that fits the guidelines? 

That’s where details like start dates, W2 vs 1099, guarantees, RVUs, and bonuses suddenly matter a lot.

Using Future-Dated Physician Contracts to Qualify for a Mortgage

One of the biggest advantages physicians have is the ability to use a future-dated employment contract to qualify for a mortgage—even if you haven’t started yet.

How future-dated contracts work

In many physician mortgage programs, lenders can use a signed employment contract that spells out:

• Your base salary or guaranteed income
  
  

• Your start date
  
  

• The terms of employment (W2 vs 1099, partnership track, etc.) 

As long as the contract meets the program’s criteria, the lender can underwrite your loan based on that future income.

Typical requirements (high level)

Every bank is a little different, but expect rules like:

• Contract must be fully executed (signed by you and the employer)
  
  

• Start date within a certain window of closing (for example, 60–90 days)
  
  

• Clear base pay or guaranteed income stated in the contract
  
  

• No major contingencies that could easily derail the offer 

This is why aligning your closing date with your start date window matters — especially when trying to secure a home loan before your residency starts.

Practical example

You’re a PGY-5 or fellow with a signed attending contract:

• Base salary: $325,000
  
  

• Start date: August 1
  
  

• You want to buy a home and close in late June or July, before you start. 

With the right physician mortgage lender, that future-dated contract may be enough to qualify you, even if your current resident income is much lower.

The key is to talk to the lender early, so:

• Your timeline lines up with their program rules
  
  

• Your agent and lender are on the same page about realistic closing dates 

When 1099 Physician Income Becomes a Problem

Here’s where things get tricky.

A growing number of physicians—especially hospitalists, anesthesiologists, emergency physicians, and certain specialists—are being hired as independent contractors (1099) instead of W2 employees.

That can be attractive for:

• Higher apparent pay
  
  

• More autonomy
  
  

• Flexibility in scheduling or multiple gigs 

But in the mortgage world, 1099 income is not the same as W2 income.

Why lenders don’t love “new” 1099 income

For traditional underwriting, lenders usually want:

• Two years of history for self-employed or 1099 income, and
  
  

• A track record that shows the income is stable and ongoing 

If you’re just switching from W2 to 1099 this year, even if the gross pay looks great, the lender may not be able to use it without:

• A full two-year tax history showing that 1099 income, or
  
  

• An exception under a specific physician mortgage program (and even those are limited).
  
  

This distinction is often misunderstood by doctors who assume higher pay automatically improves approval odds — a common issue discussed in How Physician Contracts Impact Your Ability to Buy a Home.

Common 1099 landmines for doctors

• You were W2 at your old hospital but signed a new, higher-paying 1099 contract with a new group.
  
  

• You’re transitioning from employed to locums work.
  
  

• You’re joining a group as a contracted physician with RVU or collections-based pay and minimal guarantee. 

From your perspective, you might be thinking: “This is a great move financially; my hour-by-hour compensation is way higher.”
From the lender’s perspective, it looks like: “We don’t yet know if this is stable or consistent.”

What if you’re already 1099 and want to buy?

If you’ve already been 1099 for two or more years with filed tax returns, you’re usually in much better shape. The underwriter will:

• Average your last 1–2 years of income (after expenses), and
  
  

• Look for a pattern that’s stable or increasing. 

The key point: new 1099 physician income + new contract + no tax history = very hard to use for a mortgage, unless you’re structuring it under a very specific physician program that understands your situation.

Short-Term Guarantees in Dental and Medical Contracts

Another increasingly common situation: contracts with short-term guarantees.

You’ll see this a lot in:

• Dental associate agreements
  
  

• Certain private practice or specialty group contracts
  
  

• RVU or collections-based employment models 

What is a short-term guarantee?

A short-term guarantee usually looks like:

• A 6–12 month guaranteed salary, followed by
  
  

• A switch to productivity-based pay (RVUs, collections, or profit share) 

On the surface, it’s a nice bridge: guaranteed income while you ramp up, then upside based on how busy and efficient you are.

For underwriting, though, it raises an important question:

What income do we actually use to qualify you?

Why lenders are cautious

Lenders prefer:

• Guarantees that last at least a year, and ideally longer
  
  

• Compensation structures that are predictable and easy to document
  
  

• Clear base pay, not just “estimated production-based income” 

Short-term guarantees can be an issue when:

• The guarantee is very short (for example, 6 months).
  
  

• The contract language is vague about what income looks like after the guarantee.
  
  

• The bank can’t reasonably project stable income beyond the guarantee period. 

Many underwriters are not comfortable qualifying you solely on a six-month promise when the mortgage you’re taking out is for 30 years.

Dental-specific wrinkle

Dentists, in particular, often face:

• Short associate guarantees with quick transitions to collections-based pay
  
  

• High income potential but less predictable in the early years
  
  

• Contracts loaded with production thresholds, lab cost sharing, and other variables 

For dental and other private-practice-heavy specialties, it’s essential to have:

• A lender who understands the typical structure, and
  
  

• A plan that doesn’t depend on underwriting your “best-case scenario” income. 

Timing Your Job Change and Home Purchase

If you know a job change is coming, and you’re thinking about buying a home, timing matters.

Better timing scenarios

You’re usually in a stronger position if:

• You buy with a usable W2 contract (future-dated is okay within the lender’s window), or 

• You wait until you have enough 1099 history (generally two years) if you’re going self-employed. 

Some practical timing strategies:

• Residents/fellows → attendings (W2):
  Use your future-dated attending contract under a physician mortgage program and time your closing inside the allowed window before start. 

• Attending W2 → new W2:
  If the new role is clearly better and the contract has strong guarantees, structure your home purchase based on the new contract, not the old one—again, paying attention to start date rules. 

• Attending W2 → 1099:
  If at all possible, buy while you’re still W2, before transitioning to 1099, or be prepared to wait until you have enough 1099 history. 

• New 1099 without history:
  If you’ve already made the jump, focus on stability and documentation and make a plan for when your income will be usable (often after two tax years), rather than trying to force a mortgage approval right away. 

How to Make Your New Contract “Mortgage-Friendly”

You may not be able to change every line of your contract, but you can negotiate and structure things with an eye toward underwriting.

Here are questions to consider as you negotiate or review a new physician contract:

1. Is my income W2 or 1099? 

   • If 1099, do I understand how that impacts my ability to qualify in the next 1–2 years? 

2. Is there a clear base salary or guarantee? For how long? 

   • Underwriters like clarity and duration. A one-year guarantee is often easier to work with than a six-month one. 

3. Does the contract state my start date clearly? 

   • This date will drive the window for closing if you’re using a future-dated contract. 

4. How are bonuses and production structured? 

   • Many lenders won’t use bonuses, call pay, or production income until there’s a history of receiving them (often two years). 

5. What’s my realistic timeline for buying? 

   • If a home purchase is important in the near term, you may value contract stability and W2 structure more than slightly higher variable 1099 pay. 

Bringing your lender into the conversation early—before you move money, sign a contract, or give notice—can keep you from accidentally backing yourself into a corner.

Putting It All Together

Changing jobs is normal in medicine. You’re not the first physician to upgrade your contract and wonder when you can safely buy a home without hearing “come back in two years.”

The key points:

• New physician contract + W2 + clear guarantee
  → Often very workable, especially with a physician mortgage that allows future-dated contracts. 

• New 1099 physician income without history
  → Often a problem. Plan for a longer runway before buying, or structure your transition carefully if homeownership is a near-term goal. 

• Short-term guarantees in dental/medical contracts
  → Can spook underwriters. Longer, clearer guarantees are more mortgage-friendly. 

If you’re staring at a new contract and a potential home purchase at the same time, the order of operations matters. Get eyes on both—contract and mortgage—before you lock in dates.