Three times a year, in conference rooms at the National Institutes of Health's Bethesda, Md., campus, about 1,440 permanent members of 100 study sections (accompanied by an annual total of about 1,800 ad hoc members) meet for two days to review 9,000 grant proposals. Critics of the system charge that it is cumbersome; needlessly hard on both reviewers and the reviewed; and rife with the potential for incompetent decisions, abuse of power, and conflicts of interest. Even its supporters acknowledge that it's a system that was devised for another era, a time in which funds were far more plentiful and funding decisions far easier.

Fred Bookstein OPEN TO SUGGESTION: Fred Bookstein urges a new ranking system for grant proposals.

"We are operating in the framework of a system that was created 50 years ago essentially to identify the 10 percent of grants that NIH would not fund," notes Donna Dean, acting chief...

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