New Attending Physician? Your WA Mortgage Playbook (2026)

You spent a decade in training. You finally have attending status, a real salary, and — if you just matched at UW Medical Center, Virginia Mason Franciscan, or Providence — you're about to become a Seattle-area homeowner. There's just one problem: conventional lenders see a physician with $280,000 in student loans and three months of employment history and say no.

Physician mortgage loans exist specifically to solve that problem. This post walks new Washington State attendings through exactly how these loans work, what lenders actually want to see, and the common mistakes that delay closings.

Why Conventional Underwriting Fails New Physicians

Standard Fannie Mae and Freddie Mac guidelines underwrite you the same way they'd underwrite a retail manager. They count every dollar of your student loan payment against your debt-to-income ratio, require two years of employment history in the same field, and demand 20% down to avoid PMI. For a $900,000 home in Northgate or the Central District — a reasonable price for a UW attending — that's $180,000 cash you may not have after a decade of resident salaries.

The math simply doesn't work. A $280,000 student loan balance on an income-driven repayment plan at $0/month still gets counted at 1% of balance ($2,800/month) under most conventional guidelines. Add a car payment and you've blown past the 43% DTI ceiling before your base salary even enters the picture.

How Physician Loans Are Different

Doctor mortgage programs — offered by a handful of portfolio lenders and regional banks — underwrite physicians under a completely different set of rules. Here's what changes:

• Student loans excluded or IBR-counted: Most physician loan programs either exclude student debt from DTI entirely or use your actual IBR/PAYE payment, even if that payment is $0.
• Employment contract accepted as income: You don't need a pay stub. A fully executed offer letter or employment contract showing your start date and annual salary is sufficient to qualify — even if you haven't started yet.
• Zero to 5% down, no PMI: Most programs allow 0–5% down on loan amounts up to $1.5M or higher, with no private mortgage insurance requirement regardless of down payment.
• Jumbo amounts available: In King County, where even modest single-family homes regularly exceed $800,000, the ability to finance $1M+ without a jumbo surcharge is significant.

These aren't subprime products. They're portfolio loans held by lenders who understand physician income trajectories and price the risk accordingly. For a deeper breakdown of how these programs work across the state, see my full Washington physician mortgage guide.

The Washington State Context: Why Location Matters

Washington's major medical employment hubs each come with different home-price realities, and your loan strategy should match your market.

Seattle / King County

Median single-family home prices in Seattle neighborhoods popular with new attendings — Ballard, Phinney Ridge, Montlake, Madison Park — range from $850,000 to $1.4M. A physician loan at 5% down on a $1.1M purchase means $55,000 down instead of $220,000. That's a meaningful difference when you're still paying off med school and furnishing a new home.

Tacoma / South Sound

MultiCare and CHI Franciscan are both major employers in Pierce County. Prices are lower — many neighborhoods fall in the $550,000–$750,000 range — but physician loan benefits still apply, especially the student debt treatment and contract-as-income flexibility.

Spokane / Eastern WA

Providence and MultiCare both operate large facilities in Spokane. Home prices here are dramatically lower than the west side, but the income documentation rules are identical. New attendings at WSU's Elson S. Floyd College of Medicine often use physician loans to purchase in the South Hill or Perry District neighborhoods.

Timeline: When Can You Actually Close?

This is the question I get most often from residents finishing their last rotation. The answer depends on when your contract is signed, not when you start work.

1. Contract signed → pre-approval issued: Once you have a fully executed employment contract showing base salary and start date, I can issue a pre-approval letter. This typically takes 24–48 hours once I have your documents.
2. Pre-approval → home search: In a competitive Seattle-area market, having a pre-approval letter in hand before your start date gives you the ability to make offers right away.
3. Offer accepted → closing: Standard closing timelines run 21–30 days. Physician loan underwriting is not materially slower than conventional — I've closed physician loans in 18 days when the buyer was organized and responsive.
4. Practical window: Many attendings match in March, finalize contracts in April or May, and can close on a home in June or July — before their July 1 start date if they move quickly. This is realistic and something I help clients plan for every year.

What Documents You Actually Need

New attendings are often surprised by how streamlined the documentation is compared to conventional loans. Here's what physician loan lenders typically require:

• Signed employment contract (or offer letter with salary and start date)
• Medical degree or proof of residency/fellowship completion
• Government-issued ID
• Two months of bank statements showing down payment funds
• Student loan statements (to verify payment amounts, even if $0 on IBR)
• If moonlighting during residency: two years of 1099s or tax returns

That's it. No two years of W-2s. No current pay stubs. The contract does the heavy lifting.

Common Mistakes That Delay (or Derail) Closings

After 20 years of closing physician loans in Washington, I've seen the same mistakes come up repeatedly:

• Opening new credit before closing: Buying furniture on a new card or financing equipment can shift your DTI and trigger a re-underwrite. Wait until after closing.
• Not disclosing moonlighting income correctly: If you moonlighted during residency and want to use that income, it needs to be documented properly. Trying to slip it in late creates problems.
• Choosing a lender who isn't familiar with physician programs: A loan officer who has to look up the guidelines is going to slow you down and may give you incorrect information about what you qualify for. Work with someone who closes these regularly in Washington State.
• Waiting until after you start work: You don't need to wait. The contract is enough. Starting the process 60–90 days before your start date gives you plenty of time to find a home and close without rushing.

How Physician Loans Interact With WA's Other Rules

Washington is a community property state. If you're married, your spouse's debts will be considered even if they're not on the loan — this matters for physician households where one spouse is still in training or has significant student debt. There are structuring options available, and it's worth discussing these in your initial consultation.

Washington also has no state income tax, which meaningfully increases your effective take-home pay compared to California or Oregon — an important factor when modeling how much home you can comfortably afford.

For broader context on how student loans interact with mortgage qualification across different loan types, this guide on student debt and mortgage approval covers the mechanics in detail. And if you're weighing how much to put down versus keeping cash reserves, the down payment calculator post walks through the tradeoffs.

Ready to Run Your Numbers?

If you're finishing residency or fellowship in Washington State and want to know exactly what you qualify for before your first day of attending work, let's talk. I work with physicians across King, Pierce, Snohomish, and Spokane counties and I'm familiar with the employment contracts and compensation structures at UW Medicine, Virginia Mason Franciscan, Providence, MultiCare, and most regional health systems.

Visit my Washington physician mortgage page to learn more, or schedule a consultation and I'll put together a personalized pre-approval plan based on your contract, your student debt, and your target market. There's no cost and no obligation — just a clear picture of what's possible before you start house hunting.