Physician loans in Las Vegas: how doctors can buy with 0% down
You spend a decade in school and residency, land a job paying six figures, and then a lender looks at your student loans and your thin savings and says no. There's a mortgage program built for exactly that gap. Here's how it works and when it actually makes sense.
Financing available
100%
Zero down for qualified borrowers
Maximum loan
$2M
With no mortgage insurance
Minimum credit score
680
720+ for zero down at the full amount
This one comes from a conversation with Brian Esposito, mortgage consultant at Nations Lending, who works these files regularly.
The problem the program solves is specific. A new physician isn't a credit risk in any meaningful sense — the income is coming and it's substantial. But conventional underwriting looks backward at what you've earned and what you owe, and by that measure someone finishing residency with $200,000 in student debt looks like a bad bet. This program looks forward instead.
Three things a conventional loan won't do
- No mortgage insurance, even at 100% financing — conventional loans under 20% down almost always carry it
- Future income counts — a signed employment contract can qualify you before your first paycheck
- Student loans can be excluded from your debt-to-income calculation, in the right scenario
Only a handful of banks in the country offer this, which is why the rules are unusual and why not every lender can quote it.
The closest comparison is a VA loan. If you've done the work that earns you access to a program like this, it's worth knowing it exists.
Where most physicians get disqualified
On a conventional loan, deferred student loans don't count as zero. The lender is required to count 1% of the outstanding balance as a monthly obligation. On $100,000 of student debt, that's $1,000 a month against your ratios — whether or not you're paying anything.
Work it through. Say you earn $10,000 a month and the maximum debt-to-income ratio is 45%. That gives you $4,500 to work with.
That $1,000 difference is roughly $150,000 to $200,000 of purchasing power at current rates. It's usually the difference between the house you want and the house you settle for.
One important condition. The exclusion applies when you qualify using your current income. If you're using future contract income to qualify for a larger loan, student loans come back into the calculation at that same 1%. You get one or the other, not both.
You can close before your first day
This is the part most people don't know is possible. With a fully executed employment contract, you can buy before the job begins.
W-2 employee
150 days
To start work after closing
1099 contractor
60 days
To start work after closing
Contract term needed
12 months
Three years of continuance preferred
An offer letter is enough to get the process started, but underwriting needs a contract signed by all parties before closing. It has to spell out the details: how you're paid, hours, W-2 or 1099 status, and a minimum twelve-month commitment.
Reserves are the catch
If you're qualifying on future income, you need six months of PITI in reserves — principal, interest, taxes, insurance and HOA dues. On top of that, you need enough to cover every month between closing and your start date.
Close in September with a January start and that's four additional months. At roughly $5,000 a month, you're looking at about $20,000 on top of the six-month requirement. Worth planning for early, because it's the item that most often stalls these files.
Las Vegas HOA dues matter here more than in most markets. They run anywhere from $20 to several hundred dollars a month, and they're part of the PITI calculation.
Who actually qualifies
The eligibility list has widened considerably and keeps moving. Currently it covers:
- Physicians and surgeons
- Dentists
- Nurses
- Veterinarians
- Medical technicians
- Professors and medical directors, where clinical duties are written into the contract
That last one is recent and broader than it sounds. If your work is based in a hospital setting, there's a reasonable chance you're on the list.
And this isn't only for new graduates. An established physician fifteen years into practice can use it too.
Don't disqualify yourself before asking. The eligibility list changes often enough that lenders check it fresh on every file.
Four ways to buy the same $500,000 house
Taxes, insurance and HOA are held constant across all four so the comparison is clean. These rates are examples from the time of recording — mortgage rates move daily and yours will differ.
| Scenario | Down payment | Rate | Total monthly |
|---|---|---|---|
| Physician, 30-year fixed | $0 | 7.50% | $3,829 |
| Physician, 10-year ARM | $0 | 7.125% | ~$3,700 |
| Conventional, 5% down | $25,000 | 7.125% | $3,665 |
| Conventional, 20% down | $100,000 | 6.99% | $2,992 |
The two middle rows are the interesting comparison. Nearly identical payments — about $35 apart — but one requires $25,000 at closing and the other requires nothing.
The physician program prices more aggressively on adjustable-rate products than on 30-year fixed. The 10-year ARM here is close to half a point better than the fixed version of the same program, which is why it lands so close to conventional pricing.
What else could that $100,000 be doing?
Compare the zero-down ARM at roughly $3,700 against 20% down at $2,992. About $700 a month more.
Divide $100,000 by $700 and you get roughly 143 months — about twelve years before the higher payment consumes the down payment you didn't make.
That second figure assumes a 10% average annual return, which is an illustration rather than a promise. Markets don't deliver 10% on schedule. But it frames the actual decision: this isn't really about interest rates, it's about where your capital works hardest.
There's a risk argument too. Put $100,000 into a house and the value drops, and that money is exposed. Keep it invested elsewhere and the house value drops, and you still have the same roof, the same payment, and your capital somewhere else. You don't realize equity until you sell.
This is genuinely a question for you and your financial advisor or CPA, not one with a single right answer. Both paths are defensible depending on your risk tolerance and what else you're doing with money.
What the program costs
Rates on the physician program run slightly higher than conventional — typically an eighth to a half point. The bigger difference is in what the rate costs to obtain.
Expect roughly 1.5 discount points. On a $500,000 loan that's about $7,500 more than a comparable conventional loan. That's real money and it belongs in your calculation.
Other terms worth knowing
No prepayment penalty, and you can refinance later. If rates come down, this program's rates come down with them and you can refinance within it.
New construction works. The program follows the borrower, not the property. Worth knowing in Las Vegas, where builders push their own lenders hard — builder incentives can often be negotiated to apply even when you bring outside financing, but you need representation that will actually push for it.
You can own other property. Up to three additional properties plus the one you're buying, as long as the new purchase is your primary residence. Each investment property adds a three-month reserve requirement of its own.
That last point matters more than it seems. A physician who bought a condo during school and wants to keep it as a rental while moving up can do exactly that.
The medical sector here is growing
Las Vegas was never known for medicine. That's changed as the city has expanded, and it keeps improving — more top medical professionals are relocating here every year.
If you're finishing training in California and considering a move, the combination is worth doing the math on: no state income tax, housing that costs a fraction of coastal California, and a program that lets you buy before you start. With a W-2 offer, you have a five-month window to close and get settled.
For current conditions on what your money buys here, see the Las Vegas housing market overview.
Physician loan FAQ
What is a physician loan?
A mortgage program designed for medical professionals that offers up to 100% financing with no mortgage insurance, on loan amounts up to $2 million. It allows future contract income to be used for qualification and, in the right scenario, excludes student loan debt from the debt-to-income calculation. Only a small number of banks offer it.
Can I get a doctor loan with student loan debt?
Yes, and that is largely the point of the program. On a conventional loan, deferred student loans must be counted at 1% of the outstanding balance as a monthly obligation — $1,000 a month on $100,000 of debt. The physician program can exclude student loans entirely when you qualify using your current income. If you qualify using future contract income instead, student loans are counted at that 1% figure.
Can I buy a home before starting my new medical job?
Yes, with a fully executed employment contract. W-2 employees must begin work within 150 days of closing; 1099 contractors within 60 days. The contract needs to specify pay, hours, employment status and a minimum twelve-month term. You will also need six months of PITI in reserves plus enough to cover every month between closing and your start date.
Do nurses and other medical professionals qualify, or only doctors?
The eligibility list is broader than physicians and continues to expand. It currently includes nurses, dentists, veterinarians, medical technicians, and professors or medical directors whose contracts include clinical duties. The program is also not limited to new graduates — established professionals can use it.
Is a physician loan worth it compared to putting 20% down?
It depends on what else your money could be doing. On a $500,000 purchase, zero down costs roughly $700 more per month than 20% down, which takes about twelve years to equal the $100,000 you did not put in. Whether that trade works depends on your expected return on that capital, your risk tolerance and your timeline. The program also costs about 1.5 discount points more than conventional financing. Worth modeling with a financial advisor rather than deciding on the monthly payment alone.
Does the physician loan work for new construction?
Yes. The program qualifies the borrower rather than the property, so it follows you to a new build. In Las Vegas, builders typically steer buyers toward their in-house lender with incentives attached. Those incentives can often be negotiated to apply with outside financing, but it requires an agent who will push for it.
See whether you qualify
Before you start shopping, it's worth finding out which programs you actually have access to — this one may not be the best of them for your situation. We can connect you with Brian to run the numbers, and look at homes in Summerlin, Henderson or wherever fits once you know your range.
Our office is in Summerlin, and we're happy to meet in person or over Zoom.