All career stages
Fee-for-serviceT4A incomeLocum

Your bank says no because they
don’t understand how you get paid.

You’re a physician earning $300K+ a year. You have no employer. No T4. No pay stubs. You bill through OHIP or a provincial health plan and get T4A slips. To a bank rep who’s never seen this before, you look like a freelancer. You’re not.

The Problem

Fee-for-service income doesn’t fit in a checkbox.

When you bill OHIP (or your provincial equivalent), you receive a T4A at year-end. This is technically “self-employment income” in the eyes of most lenders. That means they want 2 years of tax returns, a 2-year average of your income, and sometimes they’ll use a lower figure than your actual income on top of that.

If your income increased significantly from year one to year two (which is common for new physicians ramping up), some lenders will penalize you by averaging the two years down instead of using the higher, more current number.

Locum physicians have it even harder. If you’re doing shifts at multiple hospitals or clinics, your income looks “irregular” to a lender even though you’re working consistently. The key is finding a lender who understands the difference between irregular income and variable income from a stable profession.

What Works

How to present your income so it doesn’t get rejected.

1
Two years of T1 Generals (personal tax returns)
This is non-negotiable for self-employed income. The lender needs to see Line 15000 (total income) for the last two tax years. If you've only been practicing for one year, your options are more limited but not zero.
2
Notices of Assessment from CRA
Confirms your tax returns were accepted as filed. Some lenders won't proceed without these. You can get them from your CRA My Account in minutes.
3
T4A slips
These show your gross billings from OHIP or your provincial plan. A lender who understands physician income will use these to verify your earning capacity, not just your net taxable income.
4
Business financial statements (if applicable)
If you have overhead (clinic rent, staff, equipment), your net income after expenses is what lenders care about. Clean financials make this easy. Messy ones slow everything down.
5
A letter from your accountant
Not always required, but a letter confirming your income structure, that your practice is ongoing, and your projected earnings can help bridge any gaps in the standard docs.
The Underwriting Gap

Same T4A. Different lender. Different mortgage.

When fee-for-service income is growing year-over-year — which is normal for physicians building a practice — a 2-year average works against you. The right lender knows this. Most banks don’t.

Same Physician, Different Lenders
Dr. Mitchell · Family Med · T4A Year 1 (partial year): $195K · T4A Year 2 (full year): $310K
Bank: 2-year average
Income methodAverage of Year 1 + 2
Income used$252K
Qualifying mortgage~$1.01M
Specialist lender: most recent year
Income methodMost recent year (trending up)
Income used$310K
Qualifying mortgage~$1.24M
Same tax return. Same billings. When income grows year-over-year — which is normal for physicians ramping up a practice — averaging penalizes you for exactly how physician careers are built. $230K more qualifying power just from income methodology. The lender choice is the methodology.
Key Distinction

Walk-in clinic vs hospital vs locum. It matters to lenders.

Lowest risk
Hospital-based
Consistent billings through a single institution. Easiest for lenders to verify and underwrite. Some may treat this similarly to employment.
Medium risk
Clinic-based
Your own practice or a walk-in clinic. Lenders want to see consistent revenue and low overhead relative to billings. 2-year history is key.
Higher perceived risk
Locum
Multiple sites, variable hours. Income is often strong but looks 'irregular' on paper. Need a lender who understands the difference. Fewer options but they exist.
Worth Knowing About

The all-in-one offset mortgage. Built for lumpy income.

Most physicians don’t get paid like salaried employees. You get large deposits (OHIP billings, AFP payments, locum fees) at irregular intervals. Between deposits, your chequing account sits low. After a deposit, it spikes. Traditional mortgages don’t care about any of that.

Some lenders offer an all-in-one product that combines your mortgage, chequing, and savings into a single balance. Every dollar deposited immediately reduces your mortgage balance, which means you’re paying less interest from the moment a payment lands. When you need to pay bills, you draw from the same account. Interest is calculated daily on whatever the net balance is.

How It Works For Physicians
Traditional Mortgage
OHIP depositsSit in chequing at 0%
Mortgage paymentFixed monthly debit
Surplus cashIdle between payments
Interest calculatedOn original balance
All-In-One Offset
OHIP depositsInstantly reduce balance
All accountsSingle offset balance
Surplus cashWorking from day one
Interest calculatedDaily, on net balance
These products also tend to be readvanceable, meaning you can borrow back what you have paid down without reapplying. Useful for covering a large expense or making an investment without touching your line of credit.
Honest take: The base rate on these products is higher than a standard discounted mortgage. The savings only materialize if you have meaningful cash flow moving through the account. If you regularly have $30-80K sitting in the account between billing deposits, the daily interest offset can more than cover the rate premium. If your cash flow is thin, a traditional mortgage at a lower rate is the better call. We can run the numbers either way.
Before You Incorporate

What incorporating does to your mortgage. From a broker, not an accountant.

We are not going to tell you whether to incorporate. That is between you and your accountant. But we can tell you exactly what happens to your mortgage when you do, because almost nobody explains this part.

Here is what happens. You are billing $350K as a sole proprietor. Your T4A shows $350K. You qualify for a large mortgage easily. Then you incorporate. Your accountant (correctly) tells you to pay yourself a lower salary and keep the rest in the corp. Your qualifying income just dropped by $200K on paper. When you apply for a mortgage, the lender sees the salary number, not the billing number.

That does not mean you should not incorporate. It means you should think about the timing. If you are buying a home in the next 1-2 years, get the mortgage done first. If you already own, it matters less. And if you are already incorporated, there are ways to present your income so lenders see the full picture. That is what we do.

1
Before incorporating: get the mortgage done
Your full self-employed income on T4A qualifies you at a much higher amount than a reduced T4 salary after incorporation. If you are planning to buy, this sequencing matters more than most physicians realize.
2
Just incorporated: plan for 2 years
Most lenders need 2 years of corporate tax returns (T2s) to use your corporate income for qualification. If you just incorporated, you may be limited to your T4 salary for the next 2 filing seasons.
3
Already incorporated: optimize your application
The right broker knows which lenders will use your T4 + grossed-up dividends + a portion of retained earnings. The difference in qualifying income between a bank that only sees your T4 and a lender that sees the full picture can be $100K+.
Quick Check

Is your mortgage set up for how you actually earn?

Five questions. Takes a minute. Every answer tells you something specific about where you stand.

Mortgage Readiness: 5 Questions
Are you planning to buy a home or refinance in the next 2 years?
Do you have at least 2 years of consistent income documentation (T1 returns + NOAs)?
Does your current lender (or the one you are applying to) know how to underwrite physician income?
Have you thought about how your income structure (sole prop vs corp) affects your mortgage options?
Do you have a mortgage pre-approval that accounts for your actual earning structure?
Already incorporated? Read the incorporated physician mortgage guide
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