The Doctor’s Guide to House Hacking with a Physician Mortgage
February 13, 2022
TLDR
House hacking = buying a small multi-unit (duplex/triplex), living in one unit, and renting the others so the rent helps cover your mortgage—sometimes most of it. For residents and new attendings, it can lock in housing, build equity faster than renting, and turn your “housing payment” into a wealth-building move.
Physician mortgages are what make this realistic because they often allow low/zero down, no PMI, contract-based qualifying, and more flexible student-loan treatment—so a duplex isn’t automatically out of reach. The catch: not every physician loan allows multi-units, so lender rules matter (some allow 2 units, a few allow up to 4). The play is: find the right physician-loan lender, run the rent vs. mortgage math, be honest about landlord realities (or budget for a property manager), and plan your exit (sell after training or refinance later). If you want to explore it, DRHF can connect you with a physician-loan lender who knows multi-unit financing and can help you compare options.
What Is House Hacking—and Why Should Doctors Care?
“House hacking” is the strategy of buying a multi-unit property (like a duplex or triplex), living in one unit, and renting out the others. The rental income helps cover your mortgage, often reducing your out-of-pocket housing cost to nearly zero. For physicians, especially residents and new attendings, house hacking offers unique advantages:
Stability: Lock in housing during training instead of being at the mercy of rent hikes.
Wealth-Building: Tenants help pay down your mortgage while you gain equity.
Leverage Physician Loans: Combine low down payment and no PMI with rental income.
The result? Faster financial growth than simply renting or buying a single-family home.
Why Physician Mortgages Make House Hacking Possible
Normally, lenders shy away from giving low-down-payment loans on multi-unit properties. But physician mortgages are designed differently. These programs:
Require little or no down payment
Waive private mortgage insurance (PMI)
Allow doctors to qualify using employment contracts
Often exclude income-based student loans from debt-to-income (DTI) ratios
That flexibility means a duplex isn’t out of reach for a resident with limited savings or an attending just starting out.
Which Banks Allow Doctors to Buy Duplexes & Multi-Units?
Not every physician mortgage includes multi-unit eligibility. But some lenders do—usually for 1–2 unit owner-occupied properties (and in rare cases up to 4). Here are 7 lenders that allow multi-unit homes under their doctor loan programs:
Lender / Credit Union | Max Units Allowed | Down Payment Options | PMI | Special Notes |
2 units | 0–10% depending on loan size | No | Flexible underwriting, strong Midwest presence | |
4 units | Flexible member-based tiers | No | Credit union benefits, physician loan program with multi-unit eligibility | |
Huntington Bank | 1–2 units | 0% up to $1M; 5–10% higher tiers | No | Midwest focus, physician-friendly |
Truist | 2 units | 0–5% depending on loan cap | No | Available in South/East |
U.S. Bank | 2 units | 0–10% depending on loan size | No | Contract-based qualifying |
TD Bank | Up to 4 units | 0–10% depending on loan size | No | Rare 3–4 unit eligibility |
First Horizon | 2 (duplex) | Often 15% for duplex | No | More common in Southeast |
How a Doctor Can “House Hack” in Residency or Early Practice
Find a Physician Loan with Duplex Eligibility Work with a specialist who has owned rentals or years of experience with mulit-unit financing. This insight could help you discover additional strategies you have not thought of.
Run the Numbers Compare your projected rent against the mortgage. Even covering 60–75% of the payment can make residency life much easier. *Note you can not use future expected income to qualify.
Be Realistic About Being a Landlord From fixing a leaky sink to answering tenant calls, know what you’re signing up for—or budget for a property manager.
Plan for Resale or Refinancing Many doctors sell after training or refinance into a conventional loan later. Factor this into your timeline.
Benefits and Risks of House Hacking as a Doctor
Benefits
Offset or eliminate your housing cost
Build equity while training
Gain experience managing real estate
Create a launchpad for future investing
Risks
Maintenance headaches during busy call schedules
Needing to live next to your tenants
Possible higher down payment vs. single-family
Not every market has strong rental demand
Cheat Code For Future Wealth
House hacking isn’t just a trendy real estate phrase—it’s a legitimate way for physicians to lower housing costs and build equity during the exact years when cash flow is tight and life is busy. If you can buy a duplex (or other small multi-unit), live in one unit, and rent the other, you’re turning your “mortgage payment” into something much closer to a housing strategy—one that can reduce your out-of-pocket costs while you build long-term wealth.
The key is matching the right property with the right physician loan program. Not every doctor loan allows multi-unit financing, and guidelines vary by lender, loan size, and market. But when the program fits—and the rent math works—this can be one of the smartest moves a resident or new attending can make.
If you want to explore a physician mortgage duplex strategy, DRHF can connect you with a verified doctor-loan lender who knows multi-unit financing and can help you compare options.
