First Horizon’s physician mortgage program can be a strong fit for doctors who want low or no down payment financing and flexible treatment of student debt—but only if you live in one of the states they serve and plan to buy a primary residence. Physicians should weigh its high loan limits and contract-based income qualification against geographic and property restrictions before applying. If you want to compare this option with others, start by reviewing your eligibility by checking your rates and explore how these loans work in our physician mortgage loan guide.
What Is First Horizon Bank And How Established Is It?
First Horizon is a long-standing regional bank with roots dating back to 1864, and it operates hundreds of branches across the United States.
It has grown through expansion and mergers, including its combination with IBERIABANK in 2020, and now manages tens of billions in assets. As a federally regulated institution, it operates under oversight similar to other national banks, which you can verify through the FDIC’s overview of insured banks.
For physicians, the key takeaway is that this is not a niche or startup lender – it’s a large, established bank offering a specialized mortgage product.
How Does The First Horizon Physician Mortgage Work?
First Horizon offers a physician-specific mortgage designed to accommodate high-income potential and nontraditional financial profiles common in medicine.
Eligible borrowers typically include MDs, DOs, OMS, and DPMs, and the program requires opening a checking account with the bank. These loans are available as 30-year fixed or adjustable-rate mortgages and are structured for primary residence purchases.
Residents and fellows may qualify for smaller loan amounts due to lower current income, but the same underwriting framework applies, including the ability to factor in spousal income.
What Down Payment, Loan Limits, And PMI Rules Apply?
First Horizon allows physicians to purchase a home with no down payment, but higher loan amounts require partial equity.
- 0% down: up to $1.5 million
- 5% down: up to $2 million
- 10% down: up to $2.5 million
These loans do not require private mortgage insurance (PMI), which can significantly reduce monthly carrying costs compared to conventional loans. For context, PMI is typically required when borrowers put less than 20% down, as outlined by the Consumer Financial Protection Bureau’s explanation of PMI.
The tradeoff is that these benefits are limited to primary residences, and closing costs are not included in the zero-down structure.
How Are Student Loans And Income Treated For Physicians?
First Horizon excludes student loan debt from the debt-to-income (DTI) calculation, which can materially improve qualification for physicians with large balances.
This is one of the defining features of physician mortgages and reflects how lenders evaluate long-term earning potential rather than current debt load. In addition, physicians can often qualify using a signed employment contract – even before their first paycheck – sometimes up to six months before their start date.
This structure is particularly relevant for residents transitioning to attending roles, where income increases significantly but hasn’t yet been realized.
Who Is Eligible For A First Horizon Physician Loan?
First Horizon’s physician mortgage is available to a defined group of licensed professionals and requires standard credit and documentation criteria.
Typical requirements include:
- Minimum credit score around 680
- Proof of employment or a signed contract
- Eligible professional designation (e.g., MD, DO, DDS, DMD, CRNA, DPM, pharmacist, attorney)
- Standard financial documentation (identity, income, and tax records)
Physicians up to 10 years out of residency may still qualify, which extends eligibility beyond early-career borrowers.
What Are The Key Limitations Of First Horizon’s Program?
First Horizon’s physician mortgage has meaningful restrictions that can disqualify otherwise strong borrowers.
- Available only in select states (primarily Southeast, Northeast, and parts of Texas)
- Limited to primary residences (condos allowed, but no investment or second homes)
- No cash-out refinance or home equity access through this program
These constraints make it less flexible than some competitors, particularly for physicians relocating frequently or building a real estate portfolio.
How Does First Horizon Compare To Other Physician Mortgage Lenders?
First Horizon is competitive on loan size and down payment flexibility, but it is not the only option physicians should consider.
For example, if you want to compare underwriting approaches or eligibility differences, review this BMO physician mortgage review as a direct alternative. Some lenders may offer broader geographic coverage or different property eligibility rules.
If your goal includes second homes or more flexible property types, you may also want to evaluate lenders like those covered in this First National Bank physician mortgage review, which highlights options for secondary residences.
The key is not choosing a “best” lender, but identifying which underwriting model aligns with your career stage, location, and homeownership goals.
Is First Horizon A Good Fit For Your Situation?
First Horizon is a strong fit for physicians who want high loan limits with minimal down payment and live in an eligible state.
It is particularly relevant for:
- Residents and fellows using employment contracts to qualify
- Early-career attendings with high student debt
- Physicians prioritizing no PMI and low upfront cash requirements
It may not be a fit if you need financing outside its geographic footprint, want to purchase a second home, or plan to access equity later.
Key Takeaways
First Horizon offers physician mortgages with up to 100% financing, no PMI, and high loan limits, but only for primary residences in specific states. The program excludes student loans from DTI and allows contract-based income qualification, which can benefit residents and early-career physicians. Eligibility extends up to 10 years post-residency, but requires a qualifying profession and minimum credit standards. Limitations include no access to secondary homes or equity features, making lender comparison essential.
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