Idaho's healthcare sector is growing fast — St. Luke's, St. Al's, and Eastern Idaho Regional are all expanding. Here's how physicians, residents, and fellows can build their Idaho home with 0% down and an employment contract instead of two years of W-2s.
In This Guide
A resident finishing a 4-year program at the University of Washington or a fellow completing training at a Boise hospital faces a paradox: they're about to earn $250,000–$400,000 per year, but their current pay history shows resident-level income, and they may have $200,000–$400,000 in student loan debt. Standard mortgage underwriting looks backward — it wants two years of tax returns showing the income you've already earned, not the income you're about to earn.
For physicians relocating to Idaho to join St. Luke's Health System, St. Alphonsus, Eastern Idaho Regional Medical Center, or a private practice, the standard loan process is a barrier. The physician construction loan is designed to remove that barrier.
Our physician construction loan is a single-close construction-to-permanent program with terms designed around how physicians actually earn. Key features:
Idaho's major healthcare employers are concentrated in a few markets, each with distinct construction lending dynamics:
Boise / Treasure Valley: The largest physician market in Idaho. St. Luke's Health System and St. Alphonsus Regional Medical Center are the primary employers. Custom home builds in the Foothills, Eagle, and Meridian are common for physicians joining Boise-area practices. Loan amounts typically range from $600K to $2M+.
Coeur d'Alene / North Idaho: Kootenai Health is the primary employer. The North Idaho market attracts physicians seeking a mountain lifestyle. Custom builds on and around Lake Coeur d'Alene frequently exceed $1M.
Idaho Falls / Eastern Idaho: Eastern Idaho Regional Medical Center and Idaho Falls Community Hospital serve the region. The market is more affordable, with physician builds typically in the $450K–$900K range.
The physician construction loan is available to licensed physicians, dentists, optometrists, pharmacists, and other qualifying medical professionals at any career stage — including residents and fellows with signed employment contracts. Attendings in private practice, hospital employment, or academic medicine are also eligible.
The key requirement is a signed employment contract from a qualifying employer. The contract must specify start date, compensation structure, and employment terms. Your Construction Specialist will review your specific situation to determine program fit.
Building in Arizona?
We serve Arizona too — same programs, same specialist.
Single-close construction loans, 5% down, up to $3M. Phoenix, Scottsdale, Tucson, Flagstaff, and beyond.