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Home Loans for Surgeons: Match the Loan to How You're Paid
Straight answer first: if you're an employed W-2 surgeon, a physician loan program at a bank may be your best deal — up to $2M+ with little down, no PMI, and student debt treated gently — and a good advisor tells you that upfront. Where specialist matching earns its keep is everywhere the employed-W-2 mold breaks: private practice, 1099 and locum work, K-1 partnership income, and loan sizes above program caps.
When the physician loan is the right answer
Banks compete hard for employed physicians: low or zero down to seven figures, no mortgage insurance, contracts accepted before you start, and income-driven student payments counted instead of balances. If that's your situation, the honest move is routing you there — our network includes brokers who place physician programs, and steering you into a pricier product would be malpractice of the financial kind.
Where surgeons actually need a specialist
- Private practice owners — practice expenses, equipment depreciation, and retirement contributions shrink taxable income exactly like any business owner's. Bank statement programs read the practice's deposits; P&L-only programs work from your accountant's statement.
- 1099 and locum tenens surgeons — facility contracts paid on 1099s route to 1099 programs at ~90% of gross; varied facilities are fine with 12–24 months of history.
- New partners with K-1 income — surgical group partnership under two years old? Programs exist that read the partnership agreement and draws rather than waiting out the K-1 seasoning.
- Jumbo territory — above physician-program caps, jumbo non-QM offers flexible documentation and interest-only structures at seven figures.
- Investment property — surgery-center buildings or rentals go DSCR, where the property qualifies itself and your practice income stays out of the file.
What you'll typically need
- Employed W-2: contract or W-2s — and a physician-program comparison before anything else
- Practice owners: 12–24 months of statements or a CPA-prepared P&L
- Locum/1099: contracts and 1099s across facilities, 12–24 months
- Credit & down: mid-600s and up; down payments vary widely by program and size
The honest part
Non-QM pricing runs one to two points above conventional, and physician programs often beat both for eligible borrowers. The only defensible process is pricing all three lanes — physician program, conventional, alternative-doc — against your actual pay structure. Two minutes of questions tells us which lane you're in; the specialist you're matched with prices it in writing.
Frequently asked questions
Should a surgeon use a physician loan or a regular mortgage?
If you're employed W-2, a physician program is often the best deal — little down, no PMI, student debt handled gently — and an honest advisor routes you there. Private-practice, 1099, and K-1 surgeons usually need alternative documentation instead.
Can locum tenens surgeons get a mortgage?
Yes. 1099 programs qualify locum income at roughly 90% of gross with 12–24 months of history; working across multiple facilities is normal and fine.
My practice's write-offs make my taxable income look small. Options?
Bank statement programs (12–24 months of practice deposits) and P&L-only programs qualify you on the practice's real cash flow — your tax strategy stays intact.
I just joined a surgical group as a partner. Does my K-1 need two years?
Not always. Some lenders work from one year of K-1 plus the partnership agreement and draw schedule; non-QM options can read the agreement directly.