Mortgages for locum tenens physicians
Locum tenens pay is excellent and the work is medicine — but the paycheck is a 1099, and that single fact moves a physician from the easiest underwriting lane (salaried W-2 doctor) into self-employed analysis: two years of Schedule C, averaging, and write-off scrutiny.
The saving grace is the same-field exception. Underwriting history rules care about your line of work, not your payer: a physician who finished residency or left employed practice for locums is continuing an established medical career, and many lenders will qualify on 12 months of locum income where a career-changer would wait two years.
How lenders see a locum tenens physician’s income
Conventional analysis averages your Schedule C net — day rates minus travel, lodging, licensing, malpractice, and retirement-plan deductions — over up to two years. Because locum deductions are genuinely large, net income often lands far below gross billings. Lenders comfortable with physicians will also read your agency contracts and credentialing as continuity evidence, and a 1099 program can credit ~90% of your 1099 totals directly, sidestepping the deduction problem.
What to document
Underwriters reviewing a locum tenens physician typically want:
- Two years of federal returns with Schedule C (or one year plus prior W-2 medical employment/residency history)
- 1099s from each staffing agency
- Current and upcoming assignment contracts (dates, day rate, expected hours)
- Active medical license(s) and board certification (continuity of the profession)
- CV with employment/residency history — it documents the same-field exception
Add-backs that commonly apply
These are paper or non-recurring expenses a lender can add back to your net income — raising your qualifying figure without changing your tax return:
- Depreciation on any owned equipment or vehicle used for assignments
- One-time credentialing or multi-state licensing pushes, documented as non-recurring
- Home-office deduction where the program allows it
- Non-recurring relocation costs between assignments
Which add-backs a given lender allows varies. Bring your depreciation schedule and a CPA who can speak to your numbers. See how deductions cut both ways in the write-offs deep dive.
Best-fit loan for a locum tenens physician
1099 income program — Agency 1099s are clean, few, and large — a program that credits ~90% of 1099 totals reads a locum's real earning power without arguing about travel and malpractice deductions line by line.
Worth comparing against:
- Conventional loan — Best pricing if your Schedule C net (after add-backs) is strong — and the 12-month same-field exception makes it available earlier than most locums assume.
- Bank statement loan — Useful when deposits outrun the 1099 picture — multiple agencies, direct-contract facilities, or telehealth income stacked on assignments.
Not sure which fits? The 5-question loan quiz and the side-by-side loan comparison narrow it down.
The pitfall to avoid: letting assignment gaps read as instability
How to prepare
- Keep every assignment contract; a signed future contract is the cleanest answer to the continuity question underwriters must ask.
- If you're within two years of residency or employed practice, submit that history — it's what unlocks the shorter self-employment requirement.
- Consider timing: applying mid-assignment with a contract extending past the closing date reads far better than applying between assignments.
- Deduction planning is loan planning — the year you max every write-off is the year conventional qualifying income craters; run both loan paths before you pick.
FAQ
Physician loan programs are built around employed doctors with contracts, and many exclude pure 1099 locums — but policies vary, and some accept a signed assignment pipeline. If the physician-loan door closes, 1099 programs read locum income nearly as favorably.
Often at 12 months of locum history: residency is prior same-field employment, which is exactly what the one-year self-employment exception wants. Lenders differ (overlays), so shop the question specifically.
They thicken the return, not the concept — lenders read the federal Schedule C. Have your CPA available for a letter confirming business continuity across states, and expect a few extra letter-of-explanation requests, not a different loan.
Educational information only — not financial advice, and not a quote, pre-approval, or offer of credit. Rates and ranges are illustrative. Mortgage Merlin is a publisher, not a lender or broker.