# Physician Loan on H-1B (2026): What IMG Doctors Need

> Physician loan H-1B guide for IMG doctors: which programs accept visas, how student loans and contracts count, and the conventional backup. Compare free.

Canonical: https://www.masalaloans.com/blog/physician-loan-h1b
Author: Apurva Sanghavi
Published: 2026-10-17T18:11:49.916Z
Tags: mortgage, Small business, h1b, immigration, home buying

**Quick answer (updated October 2026):** A physician loan on an H-1B is possible, but not universal. Physician mortgage programs are lender-specific portfolio products, and many exclude or restrict non-permanent residents. Others accept H-1B doctors with conditions such as a larger down payment. When a physician program says no, a conventional loan with 5–10% down is the reliable backup.

You matched, finished residency, maybe did a fellowship, and signed with a hospital system in San Antonio or Toledo. Every attending you know bought a house with a "doctor loan" and 0–5% down. Then you call the bank and hear: "Sorry, the physician program requires permanent residency."

That answer is real at some lenders and not at others. This guide explains how physician loans work, why visa rules differ so much between them, how lenders treat student loans and employment contracts, and what to do when the physician route closes.

## What a physician loan is (and why visa rules vary)

A physician loan is not a government program. It's a product a bank or credit union designs and usually keeps on its own books, which is why the terms vary so widely. Typical features include:

- Low or no down payment without private mortgage insurance

- Higher loan amounts than many standard programs

- Flexible handling of deferred or income-driven student loans

- Closing on a signed employment contract before your start date

- Eligibility for MD, DO, and often DDS, DMD and some other doctoral professionals

Because the lender holds the risk, the lender writes its own eligibility rules. Some programs require U.S. citizenship or a green card. Some accept H-1B, O-1 or J-1 waiver doctors with extra conditions. Some change their policy mid-year. There is no single "physician loan H-1B rule" to quote, so any article that lists exact visa terms for a named bank may already be out of date.

## IMG doctor mortgage options compared

| **Option** | **Visa holders allowed?** | **Typical down payment** | **Mortgage insurance** | **Best for** |
| --- | --- | --- | --- | --- |
| Physician loan (portfolio) | Varies by lender; often restricted | Low to none, if eligible | Usually none | Green card IMGs; H-1B where a lender accepts it |
| Conventional (Fannie/Freddie) | Yes, same terms as citizens | As low as 3–5% | PMI under 20% down | Most H-1B and O-1 doctors |
| Jumbo | Lender overlays; often accepted with conditions | Commonly 10–20%+ | Usually none | High-cost metros above $832,750 |
| FHA | Not for non-permanent residents | 3.5% | MIP | Green card holders only |

The conventional row is the important one. Fannie Mae's Selling Guide (B2-2-02) makes non-permanent residents eligible "under the same terms that are available to U.S. citizens," and Freddie Mac's guide takes the same approach. That means an H-1B physician can buy with 5% down on a conventional loan even if no physician program will take them.

As of October 2026, FHA is off the table for H-1B, O-1 and other non-permanent residents under HUD Mortgagee Letter 2025-09. If you hold a green card, FHA is still available. For more on the visa-holder alternatives, see [FHA alternatives for visa holders in 2026](https://www.masalaloans.com/blog/fha-alternatives-visa-holders-2026).

## Physician mortgage for a non-citizen: what lenders ask

When a physician program does accept H-1B doctors, expect some combination of these overlays:

1. **Larger down payment** than the citizen version of the program

2. **Remaining visa validity** requirements or evidence of extension plans

3. **Lower maximum loan amount** for non-permanent residents

4. **Reserves** of several months of payments

5. **Employer type**, since cap-exempt hospital and university employers are common for IMGs

None of these come from Fannie Mae, which has no visa list and no minimum remaining validity. They are lender rules. If you work for a teaching hospital or academic medical center, our guide to [cap-exempt H-1B mortgages](https://www.masalaloans.com/blog/cap-exempt-h1b-mortgage) covers how lenders read those employers.

Doctors fulfilling a Conrad 30 commitment have their own wrinkle: a three-year service obligation in an underserved area. Our [J-1 waiver physician mortgage guide](https://www.masalaloans.com/blog/j1-waiver-physician-mortgage) covers that case in detail.

**Talk to a loan officer who's seen this before:** We shop 150+ wholesale lenders, so we can tell you which current physician and conventional programs accept your visa type before you fall in love with a house. [Get a side-by-side lender overlay comparison](https://www.masalaloans.com/contact).

## How student loans are counted

US-trained physicians often carry $200,000+ in federal student loans. IMGs may have smaller US balances but carry an education loan from an Indian bank, or have parents still paying one.

For conventional loans, Fannie Mae's B3-6-05 (updated August 2026) says:

- If the credit report shows a monthly payment, the lender uses it.

- On an income-driven plan with a documented **$0** payment, you can qualify with $0.

- If the loan is deferred or in forbearance, the lender uses **1% of the balance** or a fully amortizing payment from the documented terms.

So a deferred $180,000 balance could add **$1,800 per month** to your debts under the 1% option. Physician programs often treat deferred loans more leniently, which is one of their main selling points. Ask each lender in writing how it will count yours.

Loans from Indian banks raise separate questions about reporting and payment documentation. See [Indian education loans and your US mortgage DTI](https://www.masalaloans.com/blog/india-education-loans-us-mortgage-dti).

## Closing on an employment contract

Many physicians buy before day one. Fannie Mae's employment offer rules (B3-3.3-03, updated October 7, 2026) give two paths:

|  | **Option 1** | **Option 2** |
| --- | --- | --- |
| Paystub before loan delivery | Required | Not required |
| Start date window | None | No earlier than 30 days before the note date or no later than 90 days after |
| Transaction | Per guide | Purchase, primary 1-unit only |
| Income used | Per guide | Fixed base income only |
| Extra reserves | Per guide | 6 months PITIA or all debts through start month +1 |

Physician programs often allow longer windows, which helps a fellow finishing in June who wants to close in March. For residents and fellows, our companion post on [buying on a physician employment contract](https://www.masalaloans.com/blog/resident-fellow-mortgage-contract) goes deeper.

## Worked example: Dr. Mehta's two paths

An illustration only. Say Dr. Ananya Mehta, a hospitalist on H-1B, signs a $285,000 base contract with a hospital in suburban Columbus and wants a $650,000 home.

|  | **Conventional 10% down** | **Conventional 5% down** |
| --- | --- | --- |
| Down payment | $65,000 | $32,500 |
| Loan amount | $585,000 | $617,500 |
| Principal & interest at 7.40% | ~$4,050/mo | ~$4,275/mo |
| PMI | Yes | Yes, higher |

Rates use the Freddie Mac weekly average for a 30-year fixed, Oct 15, 2026 (7.40%), illustration only, not a quote or offer. Her gross monthly income is about $23,750, so even with taxes, insurance and PMI the housing ratio stays in a comfortable range. If a physician program accepts her H-1B with no PMI, compare the total cost, not just the down payment. Above $832,750 in a standard county, you're in jumbo territory, where visa overlays tighten.

## What the rules actually say

- **Fannie Mae Selling Guide B2-2-02 (07/28/2015):** non-permanent residents eligible on the same terms as U.S. citizens; no approved visa list. Freddie Mac's guide takes the same approach.

- **HUD Mortgagee Letter 2025-09 (Mar 26, 2025; case numbers on/after May 25, 2025):** non-permanent residents no longer eligible for FHA; green card holders remain eligible.

- **Fannie Mae Selling Guide B3-6-05 (08/05/2026):** student loans use credit report payment, documented $0 IDR payment, or 1% of balance / fully amortizing payment if deferred.

- **Fannie Mae Selling Guide B3-3.3-03 (10/07/2026):** two options for qualifying on an employment offer or contract.

## Frequently Asked Questions

**Q: Can H-1B doctors get a physician loan?**<br />A: Some can. Physician loans are lender-designed programs, and each lender sets its own residency rules. Some require a green card, others accept H-1B physicians with a larger down payment or other conditions. Because policies change, ask the lender for its current non-permanent resident guidelines in writing.

**Q: What is the best mortgage for an IMG doctor without a green card?**<br />A: Often a conventional loan. Fannie Mae and Freddie Mac treat non-permanent residents like citizens, so 5% down is possible. A physician loan is worth comparing if one accepts your visa, but total cost including PMI and rate matters more than the down payment alone.

**Q: Can I use FHA as an H-1B physician?**<br />A: No. HUD Mortgagee Letter 2025-09 removed non-permanent resident eligibility for FHA case numbers assigned on or after May 25, 2025, and HUD reaffirmed that in October 2026. Green card holders can still use FHA.

**Q: Do physician loans count my deferred student loans?**<br />A: Many physician programs are lenient on deferred student loans, but terms vary. Conventional loans count them: Fannie Mae uses 1% of the balance or a fully amortizing payment if deferred, or $0 if you document a $0 income-driven payment.

**Q: Can I close before I start my attending job?**<br />A: Usually, yes. Fannie Mae allows qualifying on an offer, and Option 2 requires a start date no earlier than 30 days before the note date or no later than 90 days after, plus extra reserves. Physician programs may allow longer windows.

## Get your IMG physician mortgage comparison in 15 minutes

Send your contract, visa documents and student loan statements, and we'll build a side-by-side lender overlay comparison: which physician programs currently accept your visa, how each counts your loans, and the conventional backup at today's pricing. We're licensed nationwide and shop 150+ wholesale lenders. Book a free 15-minute call at /contact, start your application at /apply, or call 713-366-4668.

*Masala Loans is a brand of Matador Lending, LLC (NMLS #2072896). Written by Apurva Sanghavi, President, NMLS #227127. Equal Housing Opportunity. This article is general education, not tax, legal or immigration advice — consult a qualified CPA, attorney or immigration lawyer for your situation. Program availability, rates and terms vary by lender and borrower and are subject to change; not a commitment to lend.*