Is First Horizon Physician Loan Right for You?

• Start at First Horizon's official website and look for a 'States We Serve' or 'Physician Loan Availability' page, which usually lists the states where the loan is offered (updated periodically).
• Check the NMLS Consumer Access portal by searching 'First Horizon' to see the states in which the lender is licensed to originate physician loans.
• Call the First Horizon physician‑loan helpline; a representative can confirm current state availability and note any residency‑specific rules.
• Ask your hospital or practice's HR/benefits office, as they often maintain a list of approved lenders for staff in each state.
• Before applying, obtain written confirmation from First Horizon that the physician loan is available in your state, since availability may change.

First Horizon will only consider a physician loan if you're in a state where the bank offers the product and you meet their basic credit, income, and employment thresholds.

• Confirm First Horizon operates in your state (as covered in the 'state‑availability' check).
• Be employed as a physician, resident, fellow, or graduate medical student; some programs also accept recent graduates.
• Maintain a credit score that typically meets the bank's minimum (often around 680, but verify with the lender).
• Show a debt‑to‑income ratio that generally falls below the lender's comfort level (commonly under 45 %).
• Provide proof of stable income - recent pay stubs, W‑2s, or tax returns for the last two years.
• If you're a resident or fellow, be prepared to submit documentation of your training program and expected graduation date.
• Contact a First Horizon loan officer or use their online pre‑qualification tool to submit these details and receive a preliminary eligibility decision.
• Gather the standard documents the lender requests (ID, employment verification, income statements) before the formal application.

If any of these points don't align with your situation, you may need to explore alternative lenders before proceeding.

First, pull the loan's advertised interest rate, any upfront fees, and the stated APR; then convert those figures into a single 'total cost' number you can compare.

1. Locate the nominal rate - the lender usually lists a 'fixed' or 'variable' rate (e.g., 4.75%). Note the date of that quote, because rates can change daily.
2. Gather all fees - look for origination, underwriting, processing, and any pre‑payment penalties. Fees are often expressed as a flat dollar amount or a percentage of the loan balance.
3. Confirm the APR - the APR must include the nominal rate plus financed fees, expressed as an annual percentage. If the APR is not provided, add the fee amount to the loan balance, calculate the effective annual rate, and label it 'estimated APR.'
4. Calculate the monthly payment - use the loan amount you expect to borrow, the term (commonly 15 - 30 years for physician loans), and the APR. A standard amortization formula or an online calculator will give you the payment in USD.
5. Add upfront costs - total cost = (monthly payment × number of months) + all upfront fees. This figure shows what you will actually pay over the life of the loan.
6. Run a quick comparison - repeat steps 1‑5 for a conventional mortgage or another physician‑loan offer. The loan with the lower total cost, after adjusting for any benefits like no down‑payment, is typically the more economical choice.

Tip: Write down each figure you collect and recompute the APR if fees change during underwriting; lenders sometimes adjust fees after you submit documentation.

Safety note: Verify every rate, fee, and APR figure against the final loan estimate you receive before signing.

First Horizon's physician‑loan program includes a set of features that can differ from a standard mortgage, so confirm each item directly with the lender before you rely on it.

• Down‑payment requirement - Some physician loans allow 0 % down; verify whether First Horizon offers this option for your loan amount and credit profile.
• Private mortgage insurance (PMI) - Check if PMI is waived when you put little or no money down, and whether any substitute fees apply.
• Interest‑rate lock - Ask whether you can lock the rate before closing and how long the lock lasts; some programs charge a fee for extended locks.
• Loan‑term flexibility - First Horizon may provide 15‑, 20‑ or 30‑year terms; confirm which lengths are available and how they affect monthly payments.
• Debt‑to‑income (DTI) calculation - Physician loans sometimes use a higher DTI ceiling because future earning potential is considered; request the exact formula used.
• Underwriting criteria - Inquire whether the lender requires a full credit history, or if they accept a 'physician‑only' underwriting track that weighs residency or fellowship years differently.
• Closing‑cost assistance - Some lenders offer to cover a portion of closing costs or provide a credit; ask if First Horizon has such a program and what conditions apply.
• Prepayment penalties - Determine whether there are fees for paying the loan off early, especially within the first few years.

Understanding these components lets you compare First Horizon's offer to the conventional and other physician‑loan options discussed later. Double‑check each feature in the loan estimate and the lender's disclosure documents before you sign.

Zero‑down and no‑PMI can lower the cash you need to close, but they usually raise other costs.

The upside is immediate affordability: you keep your savings for emergencies or investments, and you avoid private‑mortgage‑insurance premiums that typically run 0.3‑1.5 % of the loan balance each year. For a physician who just finished residency, this can mean buying a home sooner and preserving capital for relocation or practice expenses.

The downside is that lenders often offset the lack of a down payment with a higher interest rate or a larger loan‑to‑value ratio. A higher rate increases the monthly payment and the total interest paid over the loan's life, while a larger balance slows equity buildup and can push your debt‑to‑income ratio closer to the lender's limit. Those factors may limit your ability to refinance later or qualify for other credit needs.

Before deciding, request a Loan Estimate from First Horizon and run a side‑by‑side comparison with a conventional loan that requires a modest down payment but offers a lower rate. Calculate the total cost over the period you expect to stay in the home, and confirm that the monthly payment fits comfortably within your budget and projected income growth. Verify any rate adjustments or fees tied specifically to the zero‑down option in the loan agreement.

First Horizon's physician loan differs mainly in down‑payment and PMI rules. It typically allows 0% down and eliminates PMI, while conventional mortgages usually require at least 3% - 5% down and add PMI until the loan‑to‑value drops below 80%. Conventional rates are often lower for borrowers with strong credit, whereas First Horizon may charge a modestly higher rate to offset the zero‑down benefit. Other physician‑loan programs also offer low‑or‑no‑down options, but they can impose higher origination fees, stricter credit requirements, or interest‑only payment periods that First Horizon does not always require.

When comparing, line up the same loan amount and term, then check: (1) the advertised interest rate and whether it's fixed or adjustable; (2) all upfront and ongoing fees, including origination, underwriting, and closing costs; (3) eligibility criteria such as required physician license, minimum income, and debt‑to‑income limits; and (4) loan features like payment flexibility or interest‑only periods. Verify each figure in the lender's rate sheet and ask for a side‑by‑side cost estimate before deciding.

Pick the First Horizon physician loan that fits the career stage you're in - student, resident, fellow, or early attending - because income stability and borrowing goals differ at each point.

• Student - Expect limited or no earned income; prioritize low‑interest options that allow a small or zero down payment and defer payments until you qualify as a resident.
• Resident - Income is modest but steady; look for loans that waive private‑mortgage‑insurance (PMI) and keep monthly payments manageable relative to your resident salary.
• Fellow - Salary rises modestly; consider a slightly larger loan amount if you plan to purchase a home, but still verify that the debt‑to‑income ratio meets First Horizon's thresholds.
• Early attending - Earnings are higher and more predictable; you may qualify for larger loan sizes, optional cash‑out refinances, or faster repayment schedules, while still checking any origination fees discussed earlier.

After you've identified the stage that describes you, review the specific terms in the loan estimate, then move on to gathering the documents First Horizon will require so the application can proceed smoothly.

Gather these core documents before you start the First Horizon physician‑loan application:

• Government‑issued photo ID (driver's license or passport), current and valid.
• Proof of physician status: active medical license and, if you're still in training, a residency or fellowship verification letter.
• Employment verification: signed contract or offer letter from your hospital or practice, plus a recent pay stub (last 30 days).
• Income documentation: W‑2 forms and federal tax returns for the most recent two years; self‑employed physicians should also include Schedule C.
• Debt and asset statements: recent statements for credit‑card, student‑loan, other loans, and a bank or brokerage account snapshot showing assets.

Requirements may vary by state or lender; verify the exact list with your First Horizon loan officer before submitting.

Before you sign a First Horizon physician loan, scrutinize the agreement for hidden fees and common contract traps.

• Origination and underwriting fees - These may appear as a flat charge or be folded into the loan balance; verify the exact amount on the Loan Estimate.
• Pre‑payment penalties - Some physician loans include a fee for paying off the loan early; confirm whether a penalty applies and its schedule.
• Rate‑adjustment clauses - Even 'fixed‑rate' loans can contain provisions that trigger a higher rate after a set period; ask when and how the rate could change.
• Escrow requirements - Lenders may require you to escrow property taxes and insurance, increasing your monthly payment; check the escrow calculation on the Closing Disclosure.
• Appraisal and inspection fees - These are often billed to the borrower; confirm who pays and whether the cost can be reimbursed.
• Optional services and insurance - Product 'bundles' such as credit‑life or mortgage‑protection insurance are optional but may be pre‑selected; ensure you understand the cost and can decline.
• Late‑payment and insufficient‑funds fees - Review the dollar amount and grace period for missed or partial payments.
• Loan‑to‑value (LTV) limits and equity requirements - Occasionally a higher LTV triggers additional fees; verify the threshold in your contract.
• Documentation and admin fees - Small processing charges can add up; request a line‑item breakdown before closing.

Double‑check every figure on the Loan Estimate and Closing Disclosure, ask the lender to explain any term that is unclear, and only proceed when the total cost matches your expectations.

A resident at a midsize hospital used a First Horizon Physician Loan to buy a $300,000 starter home. The loan was structured with the typical 30‑year term, an interest rate of 5.5% (as outlined in the 'estimate your true costs' section), and no down‑payment or PMI requirement - features that many physician loans advertise.

Because the loan required no cash down, the resident closed with only the standard closing costs, roughly 2‑3% of the purchase price. Assuming $7,500 in fees, the total cash needed at signing was about $7,500 plus a modest cash reserve, which the lender asked for to cover the first two mortgage payments.

Monthly principal‑and‑interest payments work out to roughly $1,700 under the example rate and term. The resident's total yearly housing cost, including estimated taxes and insurance, landed near $22,000. These numbers line up with the 'estimate your true costs' calculations, but actual amounts will differ based on the property's tax rate, insurance premiums, and any lender‑specific fees.

Key take‑aways for residents considering the same path:

• Verify the exact rate and any discount points the lender offers; rates can vary by credit profile and market conditions.
• Confirm the required cash reserve - most physician loans still ask for 1‑2 months of payments saved.
• Ask for a detailed breakdown of closing costs before signing, so you know which fees are negotiable.

Before moving forward, request a preliminary loan estimate from First Horizon and compare it with a conventional mortgage quote. That side‑by‑side view will reveal whether the 'no‑down' benefit outweighs any higher interest or fee structures.

Always read the full loan agreement and ask the lender to clarify any clause that seems unclear before you sign.

Use this quick checklist to determine whether the First Horizon Physician Loan aligns with your situation.

• Verify First Horizon offers the loan in your state.
• Confirm you meet the physician‑specific eligibility criteria (e.g., residency status, employment with a qualifying practice).
• Compare the advertised rate and fees to your own cost estimate, remembering that actual APR can vary by lender and location.
• Assess whether the no‑down‑payment and no‑PMI features support your cash‑flow goals.
• Review the required documentation and look for any additional costs; then double‑check that rates, fees, and terms are still current (e.g., as of February 2026).