Over the past decade I've sat on 10+ NIH study sections, and chaired a few. This commentary is spot on. Consider the response to a flaw in a grant. For a newer investigator or one no one has heard of, there will be much hemming and hawing about concern about ability to execute the project. This is code for, "who is this person in our sandbox anyway?" For one of us older guys (yes, unfortunately the pronoun is mostly right), the response is, "but I'm sure he can get this done, he must have thought about this." Even a modest scoring 'bonus' for new investigators doesn't correct this bias.

On the novelty front, reviewers are trained to focus on finding flaws or absence of detail or preliminary data. The presence of any of these requires that we score down - so it's just about impossible for something truly new to get funded. Until we do the project, we don't necessarily know what problems we'll encounter or what the data will look like. The small number of NIH grants aimed at funding high-risk work by earlier-career folks (eg, the DP2 mechanism) are a great development but a tiny fraction of the portfolio. The key thing to recognize is that any move to distribute funding towards younger folks or higher-risk work causes the old guard to scream bloody murder - "what do you mean I can't have 5 R01's at a time?". For study sections, I've observed first hand that old habits favoring established investigators and low-risk, incremental work are hard to break.