Nevada Resident + Fellow Physician Loan Guide
Program figures verified July 2026 — details change; confirm your scenario with us.
The 60-second answer for Nevada residents + fellows
If you're a resident, fellow, or intern in Nevada — at Valley Hospital, Sunrise Hospital, University Medical Center (UMC) Las Vegas, Renown Reno, Saint Mary's Reno, or a smaller Nevada GME program — you can use the physician loan program to buy a home with:
- $0 down up to $1.5M (680+ FICO) or $2M (720+ FICO)
- Future attending contract income counts (typically 60-90 days before start)
- No PMI
- IBR/PAYE actual student loan payment counts vs conventional's 1% phantom
Nevada has fewer training programs than Arizona, but for those in-training in NV, the physician loan applies the same way.
Nevada GME programs (where residents + fellows train)
Las Vegas-area teaching hospitals
- University Medical Center (UMC) of Southern Nevada — Level I trauma, UNLV-affiliated, major teaching hospital
- Sunrise Hospital + Medical Center — HCA-owned, multiple programs
- Valley Hospital Medical Center — multiple programs
- Sunrise Children's Hospital — pediatric programs
- MountainView Hospital — HCA, some programs
- Mike O'Callaghan Federal Medical Center (Nellis AFB) — military programs
Reno-area teaching hospitals
- Renown Regional Medical Center — Northern Nevada's largest hospital, UNR Med-affiliated, multiple programs
- Saint Mary's Regional Medical Center — community hospital programs
- VA Sierra Nevada Health Care System — VA residency programs
Total NV GME footprint
Roughly 600-800 residents + fellows statewide (significantly smaller than AZ's 2,500+, but substantial for a state of NV's size). Growing as UNLV SOM and UNR Med programs expand.
Using future-attending income — the key mechanism
The most valuable feature of the physician loan for residents and fellows: your signed attending contract income can be used to qualify, not your current resident salary.
How it works:
- You're a PGY-3 IM resident at Renown Reno earning $72K
- You sign a hospitalist attending contract at Renown for $290K starting July 1
- You apply for a physician loan in April for a $525K home in Reno
- Underwriter uses the $290K attending contract income, not your current $72K
- You close in June, move in, then start attending July 1
Requirements:
- Signed attending contract (offer letter that's been formally accepted)
- Start date typically within 60-90 days of loan closing (some lenders flexible to 120 days)
- Acceptable employer (most hospital systems + medical groups qualify)
- Standard credit + DTI requirements based on attending income
This single feature is why many NV residents/fellows buy before their attending start date instead of after.
Common NV resident + fellow scenarios
Scenario 1: UMC IM resident → Renown Reno hospitalist
- Current: PGY-3 IM at UMC Las Vegas, $74K
- Attending: Renown Reno hospitalist, $295K, starting August
- Wants: $475K home in Reno (Damonte Ranch or NW Reno)
- Outcome: 100% LTV physician loan using Renown contract; close mid-July
Scenario 2: Renown FM grad → rural NV attending
- Current: PGY-3 Family Medicine at Renown, $76K
- Attending: rural FM practice in Elko or Pahrump, $260K, starting July
- Wants: $385K home in target town
- Outcome: 100% LTV physician loan using rural attending contract; closes June
Scenario 3: Sunrise cardiology fellow → Las Vegas attending
- Current: cardiology fellow at Sunrise, $82K
- Attending: private cardiology group Las Vegas, $640K, starting September
- Wants: $1.45M home in Henderson or Summerlin
- Outcome: 100% LTV physician loan up to $1.5M using attending contract
Scenario 4: UMC EM resident → out-of-state attending (but buying NV first)
- Less common but: Current PGY-3 EM at UMC, $73K
- Attending: Salt Lake City ER, $385K, starting July
- Wants: keeps Las Vegas as base for family during attending transition
- Outcome: Specific case — physician loan typically for primary residence where attending will work
What if you don't have a signed attending contract yet?
If you're earlier in training (PGY-1, PGY-2) with no attending offer yet:
- Standard resident qualifying: Use current resident salary for qualifying
- Buying capacity: Limited to what resident income supports (~$300K-$400K home in NV typical)
- Path: Buy modest starter home now, refinance/upgrade later when attending income kicks in
- Alternative: Wait until attending contract signed for higher buying power
NV-specific resident/fellow considerations
Cost of living in NV vs AZ
NV cost of living is similar to AZ in most measures — slightly higher in Vegas Strip-adjacent areas, comparable in suburbs.
Las Vegas rental vs buy math
Las Vegas rentals near major teaching hospitals: $1,800-$2,500/mo for 2-bed. A $400K home with physician loan = ~$2,700/mo PITI. Marginal cost increase for substantial equity build over 3-4 year residency.
Reno rental vs buy math
Reno rentals: $1,700-$2,300/mo for 2-bed. A $425K home = ~$2,800/mo PITI. Similar marginal math.
Where NV residents typically buy
Las Vegas:
- Centennial Hills (NW Vegas) — value, schools
- North Las Vegas / Aliante — closer to UMC
- Henderson — for those willing commute
- Summerlin — higher price, premium community
Reno:
- Damonte Ranch — newer construction, value
- NW Reno (Somersett area) — premium with mountain views
- Spanish Springs — value option
- Old Southwest — character + walkability
Frequently asked questions
Can I use my offer letter, or do I need a fully executed employment agreement?
Most lenders accept the offer letter once you've formally accepted (signed acceptance). Some lenders require fully executed employment agreement. Talk to Mike about your specific situation.
What if my attending start date is more than 90 days out?
Some lenders flex to 120 days; some won't go past 90. If your start date is 6+ months out, you may need to delay loan application until closer to start date.
What if my attending contract has performance bonuses I don't know amount of?
Underwriter uses base salary as guaranteed income; bonuses don't count for qualifying without history. Base salary is what matters for qualifying capacity.
Can I use my SPOUSE's attending contract for income?
Yes — if your spouse has a signed attending contract, that income qualifies the loan (with your spouse as co-borrower).
What if my attending contract is at a hospital, but my spouse and I want to live closer to ANOTHER hospital?
Home location is your choice within the metro. Lender cares about the attending contract employer, not where you live.
What about Mike O'Callaghan Federal Medical Center (Nellis) military residents?
Military residents have specific considerations. VA loan is often the better path for military physicians given $0 down + no funding fee for disabled vets + strong program fits. Sometimes physician loan still wins; depends on specifics.
Can I refinance after attending income kicks in?
Yes — this is one of the best refinances of a physician's career. See [resident-to-attending refi page concept] for details.
Talk to Mike about your NV resident scenario
Free 30-minute call. Bring your residency program, attending contract status, target NV neighborhood, and timeline.
(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
- UNR Medical School — Residency Programs
- UNLV School of Medicine — GME
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.