I doubt there will be much negotiating room with an AMC...especially as a new grad without board certification yet and no experience. Although, in my limited experience, AMCs are more willing to negotiate than private practices only offering employed positions. You may have more leverage to negotiate if you have a fellowship in an area that they have a big need.
In terms of who to ask, start with whoever sent you the contract. They can direct it from there. I think email is fine in order to lay out a counter offer, but you might get them to hide more perks in the form of "CME" money/time if you get someone on the phone. I always think backing up a proposal with a reason is a good idea. Do you bring a skill that they need? Are you invested in the region the practice is located and more likely to stay? Were you a top percentile on exams and such and have great references?
I wouldn't go crazy asking for way above what they offered because then they won't take you seriously. Ask for things like an extra week of vacation (or CME time), for them to kick in more to your retirement, or maybe a bonus for signing or passing the boards. As a new grad, this first job is very unlikely to be your last job. You'll have more ability to negotiate once you have that certificate on your wall and a few years experience. AMCs know that new grads hop jobs a bit, so that makes them even less likely to negotiate.
This is very helpful, thanks.
I like the idea of CME time and bonuses for board cert/tee cert. The only thing is that bonuses are a one time thing and don't contribute to the long term earnings. Sadly, they don't have retirement contribution.
In reply to some to some of the points you mentioned in your post that might help you all guide me or give suggestions:
1. "especially as a new grad without board certification" - I will have taken my oral and echo boards by the start date (passing results will probably be afterwards)
2. "You may have more leverage to negotiate if you have a fellowship in an area that they have a big need" - I'm not sure about the entire area, but the hospital/CT surgeons are demanding a dedicated cardiac call team with TEE cert
3. "Do you bring a skill that they need?" - CT fellowship with very good TEE training at a well regarded program, very comfortable with regional (heavy ortho place in addition to cardiac)
4. Are you invested in the region the practice is located and more likely to stay? - This the home town for my wife and I and a long term move (hopefully)
5. "AMCs are more willing to negotiate than private practices only offering employed positions." - private groups in the area offer less up front, but catch up very quickly and end up higher in the long run
6. "Were you a top percentile on exams and such and have great references?" - top percentile on every ITE/ABA exam, my reference letters are good.
How much do you ask for over initial offer? Sure, I'd love another 100K, but I want to be reasonable. What is a reasonable request that you guys have seen?
What things have you all negotiated into your contract that you are very glad you asked for?