How much house can an Arizona physician afford?
Mike Certo ·
The answer depends on career stage + specialty + employer + student loans. Here's the real math for AZ physicians at each level.
Resident affordability (PGY-1 through PGY-4+)
Residents make $60K-$85K depending on year + program. Standard mortgage math says you can afford $250K-$340K. Physician loan math (using attending contract) says you can afford $600K+ if you have a signed attending offer.
Most AZ residents who buy use one of two paths: 1. Modest starter home ($300K-$425K) — manageable on resident income alone, lifestyle-friendly 2. Attending-contract aggressive buy ($600K-$800K) — using signed attending position as qualifying income; closing date close to attending start
Both work with physician loans. Which fits depends on: - Family situation (single resident vs married with kids) - Signed attending position in hand or just hoping - Cash for closing costs ($5K-$15K typical) - Comfort with mortgage payment during transition period
Fellow affordability (PGY-5+)
Fellows make $70K-$95K. Higher than residents but still below attending levels.
Fellowships typically convert to attending within 12-24 months. Most fellows who buy use the same "attending-contract aggressive buy" strategy, since they're closer to the income jump.
Realistic AZ fellow buy: $500K-$750K with attending contract.
New attending affordability (Years 1-3)
Income varies massively by specialty. Real AZ examples:
| Specialty | Year 1 attending | Comfortable AZ home price |
|---|---|---|
| Family Medicine | $235K-$260K | $600K-$700K |
| Pediatrics | $250K-$275K | $625K-$725K |
| Internal Medicine | $260K-$295K | $650K-$775K |
| Emergency Medicine | $275K-$340K | $700K-$850K |
| Hospitalist | $260K-$310K | $650K-$800K |
| Psychiatry | $260K-$320K | $650K-$800K |
| OB/GYN | $300K-$380K | $750K-$950K |
| General Surgery | $340K-$420K | $850K-$1.05M |
| Anesthesiology | $390K-$480K | $975K-$1.2M |
| Cardiology | $410K-$520K | $1.05M-$1.3M |
| Orthopedic Surgery | $475K-$650K | $1.2M-$1.65M |
| Neurosurgery | $625K-$850K | $1.6M-$2.1M |
| Dermatology | $390K-$500K | $975K-$1.25M |
| Radiology | $390K-$510K | $975K-$1.3M |
| Plastic Surgery (private) | $400K-$650K | $1M-$1.65M |
| Dentist (general) | $175K-$240K | $440K-$600K |
| Dentist (specialty — OMFS, endo) | $300K-$500K | $750K-$1.25M |
These assume: - Physician loan, 100% financing - 6.625-pricing varies by file specifics - 28% front-end DTI target - Maricopa County property tax (0.51%) - $150K student loan balance on IBR (industry average for new attendings)
Established attending (Years 4+)
After 3-4 years, AZ attending incomes typically reach the upper end of specialty ranges. Combined with built-up cash savings, established attendings can buy more aggressively:
- Family Medicine attending year 6 — $700K-$850K comfortable, $1M reach
- Internal Medicine attending year 6 — $800K-$1M comfortable
- General Surgery attending year 8 — $1.2M-$1.5M comfortable
- Orthopedic Surgery attending year 10 — $2M+ comfortable
Established attendings often have substantial Roth + 401(k) contributions + brokerage accounts that can support asset-based qualifying for premium purchases.
How student loans change the math
Most physicians have $150K-$350K in student loans. How they're handled dramatically affects affordability:
IBR or PAYE (income-based payment)
Most physician loans use actual IBR payment. On $200K balance with $200/mo IBR, that's $200 in DTI. Doesn't crush affordability.
Standard 10-year repayment
$200K balance = ~$2,200/mo standard payment. Crushes DTI; reduces affordable home price by $250K+.
REPAYE / IBR + PSLF
For physicians at non-profit hospitals (Mayo, HonorHealth nonprofit segments, Banner UMC, university medical centers), Public Service Loan Forgiveness wipes student loans after 10 years of qualifying payments. Use IBR while in PSLF qualification.
Refinanced private student loans
Some physicians refinance to lower rates with SoFi or LendKey. Fixed monthly payment counts in DTI. May be higher or lower than IBR depending on refi terms.
How AZ employer impacts affordability
Non-profit AZ employers (PSLF-eligible)
Mayo Clinic Phoenix + Scottsdale (non-profit), Banner Health (non-profit), Tucson UMC, HonorHealth (most divisions) — all qualifying for PSLF. Use IBR + plan for loan forgiveness.
For-profit + private practice
HonorHealth's for-profit divisions, private practices, urgent care chains — typically not PSLF-eligible. May refinance student loans privately for lower rates.
Academic medical centers
Banner UMC (Tucson), Banner UMC (Phoenix), Mayo Clinic — academic positions sometimes have lower base salary but stronger PSLF + research stipends.
Real example — AZ Family Medicine attending
New attending at Banner Family Health Phoenix, year 1, $245K base salary, $185K student loans on IBR ($165/mo), $25K savings, 720 FICO. Targeting $625K Phoenix home.
Affordability math
- Monthly gross income: $20,417
- IBR student loan: $165/mo
- Other monthly debts: $400 (car)
- Target PITI: $4,200/mo (front-end 21%)
- DTI back-end: 23% (very comfortable)
- Physician loan 100% LTV pricing varies by file specifics on $625K = $4,055/mo P&I + $266 tax + $130 insurance = $4,451/mo PITI
Within DTI target. Approved without issue.
Cash needed: ~$15K for closing costs (lender credit + savings cover it). Real out-of-pocket at closing: $5K-$8K.
How Mike runs YOUR specific numbers
Send these details + I'll run scenarios: - Your degree + specialty + career stage - Current monthly income (or attending contract details) - Student loan balance + monthly payment - Other monthly debts (car, credit card minimums, etc.) - AZ market you're targeting + approximate price range
Contact Mike or call (480) 296-6513.