All of us have been brought up under the National Institutes of Health (NIH) system of sponsored research. We are grateful to it and we cherish it. By and large, it has been singularly effective in promoting and maintaining excellence in American biomedical research. I believe that the peer review system, in which I have now participated both as a recipient and as a peer, is a key element in this system. I also believe that it can and should be continually improved.
Much thought has gone into the mechanics of the peer review system. This is not my concern