When a grant proposal arrives at NIH's, Bethesda. Md., headquarters it is routed directly to the agency's Division of Research Grants. There, one of a dozen or so "referral officers" identifies the scientific field to the most appropriate of the agency's 93 standing commit- tees review to the so-called "study sections."
A study section consists of from 14 to 20 scientists representing a widerange of specialties: The Surgery, Anesthesiology, and Trauma Study Section, for example, might include biochemists, burn physiologists, toxicologists, and specialists in drug metabolism.
Each proposal gets an in-depth reading from at least two section members--referred to as the primary and secondary reviewers. When the study section meets the two reviewers discuss the proposal's scientific merit with their colleagues, and all of the reviewers in the section then vote to approve, disapprove, or defer decision on the proposal.