I've helped physicians and dentists buy homes in Seattle since 2018, usually one or two a year. Some won their home with 0% down. A few ran the numbers and chose a conventional loan instead. Both were the right call for them.
What I've learned is that the loan program is only part of an offer. How a seller reads it matters just as much. Here are the four lessons I come back to most.
"Can a 0%-down offer actually win?"
It can. A surgeon I worked with in 2019 bought with a 0%-down physician loan, and the seller accepted the offer within three days.
The loan itself isn't weak. A seller only worries about it when something around it looks uncertain: a loan officer they can't reach, a file that hasn't been reviewed, or no plan for a low appraisal.
"Why did a physician offer lose on my own listing?"
In May 2026, a physician buyer offered on one of my listings with a 0%-down loan, a contingency for financing and inspection, and a gift ready to cover a low appraisal. It was a good offer. Three other buyers waived every contingency, and the winning offer had a fully underwritten loan.
Sitting on the seller's side, I saw what they saw: certainty. Two things close most of that gap:
Get underwritten before you offer, if your program allows it. Some physician programs can't do this, so ask early. A fully underwritten loan can close in 9 to 17 days. In my experience, physician loans have usually taken 28 to 40 days. More on mortgage underwriting.
Plan for a low appraisal before you write. With nothing down, there is no equity to absorb a low value. A gift, savings set aside, or a promise to cover an appraisal gap can keep the deal intact.
"Does it matter which lender I use?"
More than most buyers expect. I tell buyers that in a 20- to 30-page offer, the lender is the single most heavily weighted item, with price a close second.
In 2022, a buyer of mine saved about a point on the rate with an out-of-state bank. The listing agent couldn't reach the loan officer and had never heard of a physician loan. I estimate it cost us real negotiating room on an $800,000 home.
A local loan officer who answers the phone, knows what physician programs require and can talk to a listing agent on a Saturday is worth more than a small rate difference. Rates shop tightly; lenders don't.
"Is a physician loan always the best choice?"
No. In my own files, conventional loans have come out ahead more often than people expect.
In 2023, a lender ran both options for a physician family, and the conventional loan with 5% down had the lower monthly payment.
In 2025, a returning physician client chose 5% down conventional.
Another physician switched to a conventional loan with 20% down for a better rate and better service.
That's why I ask lenders for both quotes on the same day, for the same home price. Rates move daily, and the gap between lenders can be wide: in October 2022, one buyer of mine saw 30-year physician loan quotes more than a full point apart.
Where to go from here
How physician loans work in Washington, who qualifies and the 2026 jumbo limit: the Seattle physician loan guide.
Real payments at two Seattle prices: physician vs. conventional loans.
How I structure a physician-loan offer to compete is in the client section of my buyer's guide.
This post is general information, not a loan offer or financial advice. I'm a real estate broker, not a lender, and I'm not paid by any lender. Confirm loan terms with a licensed loan officer.