Sacramento Physician Home Loan: 100% Financing Up to $2M (No PMI)

Doctors in Sacramento can buy a primary residence with as little as 0% down on loans up to $1.5 million, or 100% financing up to $2 million with a 720 credit score — and skip private mortgage insurance entirely. Student loans in deferment or income-based repayment? Often excluded from your debt-to-income calculation while you're still in residency or fellowship. This is the physician loan program built for the way medical careers actually work: high future income, big student debt, and a need to put down roots fast.

If you're a resident at UC Davis Medical Center, a new attending at Sutter or Kaiser, or a dentist opening a practice in Roseville — this is the kind of program most "regular" lenders aren't telling you about.

What Is a Physician Home Loan?

A physician home loan (sometimes called a doctor mortgage or medical professional loan) is a specialty mortgage program designed for medical professionals who would otherwise get squeezed by traditional underwriting. Standard mortgages punish doctors for two things: high student loan balances and short employment histories. The physician loan program fixes both.

Here's what makes it different from a conventional loan:

• No private mortgage insurance (PMI) even at 95% to 100% loan-to-value

• Up to 100% financing on a primary residence (zero down payment required)

• Student loans in deferment or IBR can be excluded from your debt-to-income ratio during residency or fellowship

• You can close up to 150 days before your start date using a signed employment contract as proof of income

• Loan amounts up to $2 million on a 1-unit primary residence

For doctors buying in Sacramento, Folsom, El Dorado Hills, Roseville, or anywhere in Placer, El Dorado, and Yolo counties, this opens the door to homes that conventional financing would either deny or load up with PMI and tighter limits.

Who Qualifies for the Sacramento Physician Loan?

At least one borrower using their income to qualify must hold one of these credentials:

• Medical Doctor (MD)

• Doctor of Osteopathy (DO)

• Doctor of Dental Science or Surgery (DDS)

• Doctor of Dental Medicine (DMD)

• Doctor of Ophthalmology (MD or DO)

• Doctor of Psychiatry (MD or DO)

• Doctor of Pharmacy (PharmD)

• Doctor of Veterinary Medicine (VMD)

• Doctor of Podiatric Medicine (DPM)

• Certified Registered Nurse Anesthetist (CRNA)

• Medical residents, fellows, or interns holding any of the above degrees

Chiropractors are not eligible under this specific program. (There are other doctor-friendly options for DCs — that's a separate conversation.)

You'll also need:

• An active employment contract or signed offer letter with a start date within 150 days of closing

• A minimum 680 FICO score (720 if you want to go 100% LTV up to $2M)

• A fully documented loan file — no AUS shortcuts on this program, which sounds painful but actually works in a doctor's favor because the underwriter can apply common sense to your file

Sacramento Physician Loan Limits and Down Payment Options

Here's the cleanest way to look at the down payment tiers:

Down PaymentFICO RequiredMax Loan Amount5% down (95% LTV)680$2,000,0000% down (100% LTV)680$1,500,0000% down (100% LTV)720$2,000,000

In a market like Sacramento and the surrounding suburbs, $1.5M–$2M with no down payment is meaningful. A $1.4M home in El Dorado Hills with zero down beats writing a $280,000 check from savings you don't have yet — especially when those funds could sit in your emergency reserves or go toward an investment property later.

A few things to keep in mind on the high-LTV options:

• Above 90.01% LTV, escrow/impound accounts are required (taxes and insurance roll into your monthly payment)

• Above 90.01% LTV, no secondary financing (no piggyback HELOCs at closing)

• No PMI at any LTV — this is the headline benefit and what separates a physician loan from a low-down-payment conventional loan

How Student Loans Are Treated (The Big One)

This is where physician loans really earn their keep, and it's the question every resident asks first.

If you're currently in residency or a medical clinical fellowship, student loan payments may be excluded from your DTI entirely when they meet all of the following:

• The loans are in deferment, forbearance, or reporting $0 due under an income-based repayment (IBR) plan

• You're qualifying based on your current residency or fellowship income

That's a game-changer. A resident earning $65,000 with $280,000 in student debt would normally see a $2,800+ phantom monthly payment added to their DTI under conventional rules — enough to disqualify them from buying anything meaningful in the Sacramento area. Under this program, that phantom payment can disappear.

If you're an attending and not in residency/fellowship, student loans are still handled more flexibly than conventional. The qualifying payment uses either:

• The actual payment shown on the credit report, or

• The IBR plan payment from your loan servicer documentation, or

• 1% of the outstanding balance (for deferred loans), or

• A documented fully amortizing payment

You generally get to use whichever path makes your file work — within program rules.

Using a Signed Offer Letter as Income (Before You've Started the Job)

Just finished residency and signed an attending contract starting in three months? You can close on a home up to 150 days before that start date.

Requirements for the offer letter:

• Fully executed and signed by all parties

• States your position/title, start date, and salary

• The only acceptable contingencies are receipt of your medical license or standard admin items (background check, drug screen, fingerprinting)

You'll need extra reserves to cover PITIA (principal, interest, taxes, insurance, HOA) for each month between your first mortgage payment and your employment start date — one additional month of reserves for every month you're not yet earning. Plan ahead and this is very manageable.

Sacramento-Specific Notes

Sacramento County, Placer County, El Dorado County, and Yolo County are full of qualifying physicians — UC Davis Health, Sutter, Kaiser Permanente, Mercy, Dignity Health, the VA Northern California system, and a wave of independent specialty practices. Median home prices in the area mean the $2M ceiling is plenty of headroom for nearly any move-up purchase in Folsom, El Dorado Hills, Granite Bay, Davis, or East Sacramento. For first-home doctor buyers in Elk Grove, Natomas, or West Sacramento, the 0% down option keeps cash free for furniture, moving, or just sleeping better at night.

One Sacramento-specific watch-out: this program is primary residence only, 1-unit only. No duplexes, no investment properties, no second homes on this loan. (Doctors who want to house-hack a duplex in midtown have other paths — different program, different conversation.)

What Properties Are Eligible?

Eligible:

• Single-family primary residences

• Condos that meet warrantability standards

• PUDs (planned unit developments)

Not eligible under this program:

• 2-4 unit owner-occupied properties

• Second homes

• Investment properties

• Manufactured or mobile homes

• Mixed-use properties

• Non-warrantable condos and condo-hotels

• Properties over 40 acres

• Working farms, ranches, or orchards

Loan Types Available

Pick the structure that fits your timeline and risk tolerance:

• 30-year fixed

• 25-year fixed

• 20-year fixed

• 15-year fixed (max 45% DTI)

• 5/6 ARM (max 45% DTI, $350,000 minimum loan amount)

• 7/6 ARM ($350,000 minimum)

• 10/6 ARM ($350,000 minimum)

For most Sacramento physicians, the 30-year fixed is the default unless you're planning to leave the area within 5–7 years, in which case the 7/6 or 10/6 ARM can save real money on rate.

Frequently Asked Questions

Can I get a Sacramento physician home loan with no down payment?

Yes. With a 680 FICO, you can finance 100% up to $1,500,000. With a 720 FICO, you can finance 100% up to $2,000,000 on a primary residence in the Sacramento area.

Does a physician home loan require PMI?

No. This physician loan program does not require private mortgage insurance, even at 95% or 100% LTV. It's the single biggest monthly savings compared to a low-down-payment conventional loan.

Can residents and fellows get a doctor mortgage in Sacramento?

Yes. Medical residents, fellows, and interns who hold an MD, DO, DDS, DMD, DNP, or DNAP degree are eligible — with student loans in deferment or IBR potentially excluded from the debt-to-income calculation during residency or fellowship.

What credit score do I need for a Sacramento physician loan?

The minimum is a 680 FICO. A 720 FICO unlocks the full 100% financing up to $2 million. Credit history must cover at least 24 months and show no housing late payments in the past 12 months.

Can I use an offer letter to qualify before starting my new job?

Yes. A fully executed employment contract or offer letter can be used to qualify, with closing allowed up to 150 days before your start date. You'll need reserves to cover the gap between your first mortgage payment and your first paycheck.

Is the physician loan available for refinancing?

Yes. Rate and term refinances are eligible on a primary residence. Cash-out refinances are not available under this program. Properties currently listed for sale, or listed within the last 6 months, are not eligible for refinance.

Can I buy a duplex in Sacramento with a physician loan?

Not under this specific program — it's 1-unit primary residence only. For doctors interested in house-hacking a duplex, triplex, or fourplex in Sacramento, there are separate loan programs that work for multi-unit purchases.

What's the maximum debt-to-income ratio?

50% DTI for most loan structures. 45% DTI for ARM loans and 15-year fixed loans, and for any loan above 95% LTV.

Do I need cash reserves?

Loans up to $1.5 million at 95% LTV or below require zero months of reserves. Loans between $1.5M and $2M, or any loan above 95% LTV, require 3–6 months of PITIA in reserves. Gift funds can count toward reserves.

Are chiropractors eligible?

Not for this specific program. There are other physician-adjacent loan options that may be a good fit — worth a separate conversation.

Talk to a Sacramento Mortgage Broker Who Knows This Program

The Chris Kennedy Team works with physicians, dentists, CRNAs, and medical residents across Sacramento, Placer, El Dorado, and Yolo counties — and the doctor loan is one of the most underused tools in the local market. Most agents and even most lenders don't know it exists, which is why so many doctors end up overpaying for PMI or putting down cash they didn't need to part with.

If you're a doctor planning a purchase in Sacramento, Folsom, Roseville, Elk Grove, El Dorado Hills, Davis, or anywhere in the four-county area, getting pre-qualified is the next step. It doesn't pull hard credit, doesn't lock you into anything, and gives you the real numbers so you can shop with confidence.

Call (916) 794-0777 or visit thechriskennedyteam.com to start the conversation.

The Chris Kennedy Team at Reliant Lending, NMLS #971546. All loans subject to credit approval. Program terms and eligibility subject to change without notice. Equal Housing Lender.