Residents + Fellows in Arizona — Buy a Home Before Your Attending Salary Starts

Arizona Residents + Fellows: Buy a Home Before Your Attending Salary Starts

By Mike Certo, Cornerstone First Mortgage · NMLS #260555 · Updated May 24, 2026

The 60-second answer

If you're a resident, fellow, or intern in Arizona with a signed attending employment contract starting within the nextwithin 150 days of start (varies by program), you can qualify for a physician loan based on your future attending salary — not your current resident pay.

That means: - You can buy a home before your attending salary starts - $0 down up to $1.5M (with 720+ FICO) or $2M (with 720+ FICO) - No mortgage insurance at any LTV - Heavy student loan debt counted as actual IBR/PAYE payment, not 1% of balance - Closewithin 150 days of start (varies by program) before your start date if employment + contract documentation is in order

This is the single feature of physician loans that makes them dramatically better than conventional, FHA, or VA for new-attending borrowers. No other major mortgage product allows future-attending-income qualifying.

Why this matters: the resident → attending income jump

A typical Arizona residency salary in 2026: - PGY-1 (intern): $62,000-$68,000 - PGY-2: $64,000-$71,000 - PGY-3: $67,000-$74,000 - PGY-4 + fellowship: $70,000-$80,000

A typical Arizona new-attending salary in 2026: - Primary care (FM, IM, Peds): $230,000-$310,000 - Hospitalist: $260,000-$340,000 - Emergency Medicine: $300,000-$400,000 - Anesthesiology: $380,000-$500,000 - Surgery (general): $380,000-$520,000 - Specialty surgery (orthopedics, neuro, cardio-thoracic): $500,000-$1.2M - Radiology / Pathology: $400,000-$550,000

The jump from resident salary ($65K-$80K) to attending salary ($230K-$1.2M) happens in a single day. Conventional mortgage underwriting can't accommodate that jump. The physician loan can.

How the contract-as-qualifying-income works

Standard mortgage underwriting requires 2 years of W-2 income at the salary level supporting the loan. For a new attending earning $350K, conventional underwriting needs 2 years of W-2s showing $350K — which by definition you don't have if you're still a resident.

The Redwood Sequoia Medical Professionals Program (Mike's primary physician loan product) accepts:

Signed attending employment contract As the income source
within 150 days of start (varies by program) Of loan closing
Current residency status Documented (showing you're completing training, not jumping employers mid-residency)
Standard physician loan terms Apply (100% LTV, no PMI, etc.)

What the lender verifies: - The attending contract is fully executed by both parties - The starting compensation is documented in the contract - The employer is a legitimate AZ medical practice or system - Your residency is in good standing (training program letter) - Your credit + DTI meet program standards

The contract is the qualifying income for underwriting purposes. Your current resident pay is treated as supplemental (counts but isn't the primary qualifier).

The math: PGY-3 resident buying a $750K home

A typical scenario this year — PGY-3 internal medicine resident at Banner-University Medical Center Phoenix, signed attending contract with HonorHealth starting July 1:

Current situation: - PGY-3 salary: $72,000 - Attending contract: $295,000 starting July 1 - Student loans: $310,000 (IBR payment $310/mo) - Other debts: $480/mo (car + minimum credit card payments) - Liquid savings: $22,000 - FICO: 740 - Wants: $750,000 home in Arcadia or North Central Phoenix, close before July 1 start date

Conventional loan math: - Lender uses PGY-3 income: $72K = $6,000/mo - Lender adds 1% of student loan balance: $3,100/mo phantom payment - DTI: ($3,100 student + $480 other + projected $4,800 PITI) / $6,000 = 140% → declined

Physician loan math (Redwood Sequoia): - Lender uses attending contract: $295K = $24,583/mo - Lender uses IBR student loan payment: $310/mo - DTI: ($310 student + $480 other + projected $4,800 PITI) / $24,583 = 24% → easy approval at 100% LTV

Same borrower, same home, completely different outcome based on underwriting rules.

Closing before your start date

The Redwood Sequoia program allows closing within 150 days of start (varies by program) before your attending start date — provided:

Your attending employment contract is fully signed
Your start date is documented and within the closing window
Your residency program completion is on track (training letter from your program director)
Your credit and DTI meet program standards

This timing matters because: - Residents often need to move to a new city for their attending position - Inventory in attractive AZ neighborhoods is competitive — having a closing date you control helps - Avoiding double-rent / temporary housing reduces transition friction - Your spouse and kids can settle into the new home before your attending start date

Mike has closed multiple resident → attending physician loans with closing dates 45-60 days ahead of attending start. The key is having all the contract and program documentation in order at the start of the process, not scrambling for it during underwriting.

What if my contract has a deferred start date (more than 90 days out)?

Some attending contracts have start dates further out — particularly for new attendings transitioning between training programs, or for surgical specialties with complex onboarding. The Redwood Sequoia program's standard close-before-start window iswithin 150 days of start (varies by program); contracts with longer deferrals get evaluated case-by-case.

Options for deferred-start scenarios:

Wait to apply Until your contract start iswithin 150 days of start (varies by program)
Apply under conventional With your current resident salary (caps your loan amount but works for smaller purchases)
Consider an extended-lock arrangement With the lender — some lenders allow 90-180 day rate locks for confirmed attending contracts
Bridge financing If you need to act on a specific property before your contract start window opens

If you have an unusual timeline (e.g., 6-month deferred start, fellowship + immediate attending sequence, post-doc → attending), the conversation with Mike is worth having before you commit to any home shopping path.

What about my student loans?

This is the second-biggest physician loan advantage after the 100% LTV / no-PMI. Standard underwriting treats student loans poorly for residents and new attendings:

Conventional: Counts 1% of loan balance as phantom monthly payment (so $300K balance = $3,000/mo phantom)
FHA: Counts greater of 1% of balance OR actual payment (slightly better but still painful)
VA: Similar treatment

Physician loans (Redwood Sequoia) handle student loans more realistically:

IBR (Income-Based Repayment) — uses actual IBR payment, often $100-$500/mo on $200K-$400K balances
PAYE / REPAYE — uses actual payment
Standard 10-year repayment — uses actual standard payment
Income-Driven Repayment with $0 payment — typically uses $100/mo placeholder or a small documented amount

For a resident with $310K in student loans on IBR with a $310/mo actual payment, the DTI math difference between conventional ($3,100 phantom) and physician loan ($310 actual) is $2,790/month — enough to swing a $400K loan approval from denial to easy approval.

Bring your most recent IBR/PAYE/REPAYE statement to your pre-approval — it's the single most important document for new-attending qualification.

Eligible residency programs in Arizona

Mike has originated physician loans for residents/fellows training at AZ programs including:

University of Arizona College of Medicine — Tucson (Banner-University Medical Center Tucson)
University of Arizona College of Medicine — Phoenix (Banner-University Medical Center Phoenix)
Mayo Clinic Arizona (Mayo Clinic Phoenix + Mayo Clinic Scottsdale)
HonorHealth Scottsdale Osborn Medical Center
HonorHealth John C. Lincoln
Dignity Health St. Joseph's Hospital and Medical Center
Dignity Health Chandler Regional Medical Center
Banner Estrella Medical Center
Banner Gateway Medical Center
Phoenix Children's Hospital
Valleywise Health (formerly Maricopa Integrated Health System)
AT Still University / SOMA + ASDOH (osteopathic and dental residencies)

If your program isn't on this list but you're an AZ resident, the loan still works the same way — Mike's team has experience across the AZ medical training ecosystem.

Common new-attending buyer scenarios

Current: Banner-University PGY-3, $72K
Attending: HonorHealth hospitalist, $285K, starting June 30
Wants: $695K home in Arcadia
Outcome: 100% LTV physician loan, closes late May, family moves in before start date

Scenario 2: PGY-5 cardio-thoracic surgery fellow → AZ attending

Current: 2nd year fellowship, $82K
Attending: Phoenix area cardiothoracic group, $620K base + bonus structure, starting August
Wants: $1.6M home in Paradise Valley
Outcome: Loan amount supports the purchase under the program's $2M cap with 720+ FICO at 100% LTV — though many surgery attendings put 10-20% down to keep the monthly payment lower

Scenario 3: New dental school graduate → associate position

Current: ATSU dental school graduate, recently passed boards
Position: Associate dentist with established AZ practice, $180K base + production bonus, starting 60 days after closing
Wants: $475K starter home in Gilbert
Outcome: 100% LTV physician loan, closes alongside dental practice acquisition financing through a separate program

Scenario 4: PharmD residency → clinical pharmacist

Current: PGY-1 pharmacy residency at Banner, $50K stipend
Attending: Clinical pharmacist at Mayo Phoenix, $135K, starting July
Wants: $425K home in Mesa
Outcome: 100% LTV physician loan works; PharmD income tier is lower than MD but the program math still applies

Important caveats

Your contract is real and binding. The lender will verify with the employer that the contract is signed and the start date is firm. Letters of intent, verbal offers, or contracts pending negotiation don't qualify.
Your credit must support it. 720+ FICO opens the highest loan tier ($2M @ 100%). 680-719 still qualifies at $1.5M @ 100%. Below 680 — call to discuss.
You can't change jobs between closing and start date. If your situation changes (you decline the offer, the employer rescinds, the contract gets restructured), the loan terms can be affected.
Manual underwriting takes time. Physician loans require full manual underwrite (no automated approval). Plan for 30-45 days from application to close.
Documentation discipline matters. Have your contract, residency completion letter, IBR statement, 2 years of W-2s, and other standard mortgage docs ready at application — not piecemeal during underwriting.

Frequently asked questions

What if my attending contract is signed but I haven't matched my fellowship yet?

The loan qualifies on the attending contract once it's signed. Your fellowship match is independent — what matters is the attending position you're going to. {#faq-fellowship-match}

Can I qualify if my contract has a relocation bonus or sign-on bonus?

Yes. The lender will use your base salary as the primary qualifier; relocation and sign-on bonuses are typically treated as supplemental (count for cash to close, may count for DTI depending on structure). Bring the full contract — the underwriter reviews bonus structures during qualification. {#faq-bonus-structure}

What if my spouse is also a resident or attending?

Even better. Dual-physician households often stack to support larger purchases. Both incomes count fully — your attending contract + your spouse's attending contract (or current attending income if they're already practicing). {#faq-dual-physician}

I'm at a residency in another state but my attending position is in Arizona. Does that work?

Yes. Geography of your current training doesn't matter — what matters is where the attending position is. Out-of-state residents PCSing to AZ for their attending start are common physician loan borrowers. {#faq-out-of-state-resident}

How much will my monthly payment actually be?

For a $750K home, $0 down, 100% LTV, 30-year fixed at current rates (~6.75% as of May 2026), the principal & interest alone is ~$4,860/month. Add Arizona property tax (~$3,750/year on a $750K Phoenix home = $313/mo) + homeowners insurance (~$180/mo) = roughly $5,350/mo PITI. No PMI. Use the calculator for your specific scenario. {#faq-monthly-payment}

What if my residency program is in jeopardy or I'm not on track to complete?

The lender requires a residency program completion letter from your program director confirming you're on track to finish and that your attending start date is realistic. If you're in remediation or your training timeline is uncertain, the lender will scrutinize this carefully — call to discuss before committing to a home shopping path. {#faq-residency-jeopardy}

Talk to Mike about your resident/fellow → attending move

Free 30-minute call. Bring your situation — current PGY year + program, attending contract status, target AZ neighborhood, timeline. Mike will walk through actual numbers, the closing timeline, and what to gather for your pre-approval.

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(480) 296-6513 · Mike Certo, NMLS #260555 · Cornerstone First Mortgage NMLS #173855

Sources

Redwood Residential Acquisition Corporation — Sequoia Medical Professionals Program Eligibility Guide v1.1 (effective March 2, 2026)
AZ medical residency programs (compiled from ACGME-accredited program list, 2026)

Mike Certo NMLS #260555 · Cornerstone First Mortgage NMLS #173855 · Equal Housing Lender. Educational content, not a loan commitment. Specific eligibility per Redwood Sequoia program; subject to change. Closing-before-start-date approval depends on contract verification + program completion letter + standard underwriting. Loans subject to buyer and property qualification.