A doctor loan often requires no down payment or private mortgage insurance (PMI). Avoiding mortgage insurance can typically save hundreds per month in a mortgage payment. Most of the time a person would have to put at least 20% down to avoid mortgage insurance. In addition, doctor loans may not include student loans in the debt ratio calculation. This is important because many residents and fellows would not qualify for a mortgage loan or would have to get a less expensive home if student loans were included in their debt ratio. In order to qualify for doctor loans, some banks require the physician to open an account at the bank from which the mortgage is paid. Depending on the down payment made, some of these programs offer loans into the multi-million dollar range. Typically, they loans are only for primary, owner-occupied properties, but some are available for second homes. They can be used for purchase and often for refinance or construction as well.