Resident + Fellow Pre-Closing Playbook (Nevada) — 60-90 Day Pre-Job Start
Program figures verified July 2026 — details change; confirm your scenario with us.
The 60-second answer
For Nevada residents + fellows transitioning to attending positions, the pre-closing window is one of the most valuable mortgage opportunities in your career.
Key fact: Physician loan programs typically allow you to close on a home 60-90 days BEFORE you start your new job, using your signed attending offer letter as qualifying income.
This enables:
- Family settled before job stress of new role
- Move-in BEFORE residency/attending start
- Avoid temporary housing logistics
- Use future income (attending salary) instead of current (resident salary)
Most common scenarios: 1. Resident → Attending transition — Use attending contract for purchase 2. Fellow → Attending transition — Same approach 3. Specialty residency → Specialty attending — Same approach
This page walks through the pre-closing playbook step-by-step.
The 60-90 day window explained
Why 60-90 days?
Physician loan programs accept your signed attending offer letter for qualifying purposes, provided your start date is within typically 60-90 days of closing. Some programs allow 120 days.
What "60-90 days" means
- Day 0 (today): Resident/fellow at current job
- Day -60 to -90: Sign attending contract
- Day -90 to -45: Apply for mortgage; start home search
- Day -45 to -30: Under contract on home
- Day -30 to -7: Close on home; move in
- Day 0: Attending job starts; you're already settled
What income gets used
- Current resident salary ($63K-$78K typical)
- Plus signed attending contract income ($245K-$725K depending on specialty)
- Lender uses higher amount (attending contract) for qualifying
This dramatically expands purchase capacity.
Pre-closing playbook step-by-step
6 months out (PGY-3 in Match year + transition year)
Steps:
-
Update credit + finances
- Get FICO scores from all 3 bureaus
- Pay down credit cards if needed
- Avoid new debt
- Save for closing costs + reserves
-
Get on IBR/PAYE for student loans
- Critical: IBR/PAYE actual payment counts vs 1% phantom
- $300K loans on IBR: ~$300/mo (counted)
- $300K loans without IBR: ~$3,000/mo (phantom counted)
- This difference is massive for qualifying
-
Save documentation
- W-2s from past 2 years
- Tax returns from past 2 years
- Pay stubs from current resident position
- Recent bank statements
4 months out
Steps:
-
Initial Mike consultation
- Free 30-minute call
- Pre-qualify based on attending offer
-
Research target neighborhoods
-
Visit area (if relocating)
- 1-2 weekend visits to scout
- Confirm target neighborhoods
3 months out (typically April for July start)
Steps:
-
Sign attending contract
- Formally accept offer
- Get written contract documenting terms
-
Apply for pre-approval
- Submit attending contract + income docs
- Mike processes within 24-48 hours
- Get pre-approval letter for home shopping
-
Engage local realtor
- Mike refers to vetted physician-friendly NV realtors
- Start active home shopping
2 months out
Steps:
-
Make offers + go under contract
- Find specific home
- Submit offer
- Negotiate
- Standard contract acceptance
-
Inspections + appraisal
- Home inspection
- Lender appraisal
- Verify property condition
1 month out
Steps:
-
Final loan approval
- Underwriting completes
- Cleared to close
-
Coordinate closing
- Schedule closing day
- Wire funds for closing
-
Move logistics
- Pack + organize move
- Coordinate utilities + services
Closing + Move-in (typically late June)
Steps:
-
Close on home
- Sign loan documents
- Pay closing costs from funds
- Receive keys
-
Move in
- Family settles
- Establish home in new community
July 1 — Attending job starts
Steps:
- Begin new role
- Family already settled
- No housing stress on day 1
Common pre-closing scenarios
Scenario 1: PGY-3 at UMC → UMC hospitalist attending
- Current: PGY-3 IM at UMC, $72K salary
- Attending offer: UMC hospitalist, $295K, starting July 1
- Wants: $625K Henderson Cadence home
- Pre-closing timeline: April → mid-July
- Path: Physician loan using attending contract income
- Outcome: Family in Cadence before residency start
Scenario 2: UNLV SOM MD → Sunrise attending
- Current: PGY-3 IM at UMC (UNLV SOM grad)
- Attending offer: Sunrise hospitalist, $310K, starting July 1
- Wants: $585K Centennial Hills home
- Path: Standard pre-closing using attending contract
- Outcome: New hospitalist + new home concurrent
Scenario 3: Out-of-state residency → NV attending
- Current: PGY-3 at UCSF in San Francisco
- Attending offer: Renown Reno hospitalist, $295K, starting August
- Wants: $525K Damonte Ranch home
- Path: Pre-closing process for NV purchase from out-of-state
- Outcome: NV move + attending start coordinated
Scenario 4: Specialty fellow → specialty attending
- Current: 2-year cardiology fellow at Mayo Clinic
- Attending offer: LV private cardiology group, $625K, starting July
- Wants: $1.4M Summerlin home
- Path: 100% LTV physician loan up to $1.5M using attending contract
- Outcome: Specialty attending + premium home
Scenario 5: Couples Match transition
- Both PGY-3, both matching to attending positions
- Combined attending: $585K
- Wants: $725K Henderson family home
- Path: Combined attending contracts for two-income physician loan
- Outcome: Couples Match + family home settled
Pre-closing budget realities
Cash needed at closing
- Closing costs: $8K-$15K typical for $625K-$725K home
- Reserves: 2-6 months of PITI ($6K-$15K typical)
- Moving costs: $3K-$10K (varies by distance + amount)
- Setup costs: $2K-$5K (utilities, furnishings, settling)
Total pre-closing cash: $19K-$45K typically
For resident-to-attending transitioning physicians: build savings during PGY-2 + PGY-3 to handle this.
Monthly cash flow planning
- Current resident salary: $63K-$78K
- Future attending salary: $245K-$725K
- New mortgage payment: $3K-$10K/month
- Need to bridge current → future income transition
Many physicians use signing bonus or relocation package for closing costs.
NV-specific pre-closing considerations
NV state licensing
- NV medical license required for NV practice
- Reciprocity from other states (varies)
- Complete before start date
Multiple NV employer scenarios
- Some physicians work multiple NV facilities
- Combined income from various sources documented
Tax benefits beginning
- Move on/about residency start = establish NV residency
- Tax benefits begin immediately
- Consult CPA for optimal timing
Frequently asked questions
What if my attending contract is signed but not formally executed?
Most lenders accept signed offer letter even without formal executed contract. Mike will model your specific scenario.
What if my start date is more than 90 days out?
Some lenders allow 120 days. If significantly farther, may need to wait closer to start date.
What if my attending offer is contingent on residency completion?
Standard scenario. Most contingencies (completing residency, passing boards) acceptable. Mike navigates.
What about contingencies on board scores or other?
Some contingencies acceptable; some not. Verify with Mike.
Can I close DURING residency (not at transition)?
Yes — current resident salary alone enables purchase. Typically smaller home ($325K-$425K). Pre-attending timing not required.
What about the 6-month student loan IBR rule?
IBR/PAYE actual payment counts immediately. Don't need 6 months of receipt for student loan payment. Just need to be on IBR/PAYE plan.
What if I'm transitioning from out-of-state to NV?
Standard scenario. NV attending contract qualifies. Coordinate out-of-state realtor + Mike for NV-side.
Can I rent first then buy in residency?
Yes — many physicians rent first 6-12 months in residency. Then buy. Standard approach.
What about closing costs from signing bonus?
Common scenario. Sign-on bonus paid before closing can fund cash to close. Sign-on bonus paid after closing not counted for qualifying.
Can my spouse co-sign with employment outside medicine?
Yes — combined household income strengthens qualifying. Standard co-borrower approach.
Talk to Mike about your pre-closing scenario
Free 30-minute call. Bring your residency program, attending contract status, target NV neighborhood, timing.
(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
Mike Certo · NMLS #260555 · Cornerstone First Mortgage NMLS #173855 · Equal Housing Lender. Educational content, not a loan commitment. Loans subject to buyer and property qualification.