Physician Mortgage Down Payment & PMI: What Doctors Should Know
Jessica Hegge
One of the most attractive features of physician mortgage programs is how they handle the down payment and private mortgage insurance. For doctors who have spent years in training without time to build a large cash reserve, these programs can make homeownership possible far sooner than a conventional loan would.
Dr. Home Finance is a research and matching service, not a lender. We help doctors compare banks that run physician mortgage programs so you can weigh down payment and PMI options that fit your goals.
What PMI is and why it usually applies
Private mortgage insurance protects the lender, not you, when you put down less than 20% on a conventional loan. It is an added monthly cost that does nothing for your equity. On a standard loan, avoiding PMI means saving up a full 20% down payment, which can take years on a physician's post-training timeline.
Why physician programs skip PMI
The signature benefit of most physician mortgage programs is that they waive PMI even when you put down less than 20%. Lenders extend this because physicians, as a group, have historically been low-risk borrowers with strong income trajectories. By removing PMI, your monthly payment can be lower than a comparable conventional low-down loan that carries it.
This single feature is why many doctors choose a physician program over a conventional one early in their careers. You can compare how different banks structure this in our directory of physician mortgage banks.
Low and no down payment options
Down payment requirements vary widely across physician programs. Some lenders offer very low down payment tiers, and some advertise up to 100% financing for qualifying physicians, meaning little or no money down. Others ask for a modest down payment that still falls well below the conventional 20% threshold.
The right tier depends on your cash position, your market, and your comfort with a larger loan balance. Use our mortgage calculator to see how different down payment amounts change your monthly payment and total interest.
The opportunity cost of tying up cash
Putting more money down lowers your loan balance and monthly payment, but it also locks up cash that could serve other purposes. For a newly minted attending, that cash might be better held as an emergency fund, used to pay down high-interest debt, or invested. Home equity is relatively illiquid; once it is in the house, accessing it requires selling or borrowing against it.
This is the core trade-off. A low- or no-down option preserves flexibility, which can be valuable when your career and finances are still stabilizing. Our guide on student loans and affordability covers how this fits into the broader picture of what you can comfortably carry.
When putting more down still makes sense
Less down is not always the better move. Consider a larger down payment when:
You have ample cash reserves beyond your emergency fund and other goals.
You want to reduce your monthly payment to improve cash flow.
A lower loan-to-value ratio helps you qualify or improves the terms a lender can offer.
You are buying a long-term home and want to build equity faster.
The decision is personal and depends on your full financial picture. Reviewing it with a banker who works with physicians regularly, which you can find through Get Matched, helps you weigh the specifics.
How this differs from FHA and conventional
FHA loans allow low down payments but require mortgage insurance that can be difficult to remove. Conventional loans require PMI under 20% down but let you cancel it once you reach sufficient equity. Physician programs aim to skip PMI entirely while keeping the down payment low. Each path fits different situations; our physician loan vs conventional and FHA comparison lays out the trade-offs in detail. For the fundamentals, see Physician Mortgage 101.
Frequently asked questions
Do all physician mortgages skip PMI?
Waiving PMI is the defining feature of most physician programs, but specifics vary by lender. Confirm with each program you compare.
Can I really buy with no money down?
Some lenders offer up to 100% financing for qualifying physicians, while others require a modest down payment. Availability depends on the lender, your profile, and your market.
Is a low down payment risky?
It means a larger loan balance and more interest over time, and less equity cushion if home values fall. It also preserves cash for other priorities. The right choice depends on your situation.
Should I wait to save 20%?
Not necessarily. Because physician programs waive PMI at lower down payments, waiting years to reach 20% may not provide the benefit it would on a conventional loan.
Compare your options
Down payment and PMI policies differ meaningfully from one bank to the next. Get matched to compare physician programs side by side and find the structure that fits your finances.
Reviewed by Jessica Hegge, Partner at Dr. Home Finance. Dr. Home Finance is a research and matching service, not a lender or broker; all loan terms are provided by third-party lenders and subject to their approval. Equal Housing Opportunity.
