The PULHHEEMS is a system of grading physical and mental fitness used by Britain's armed forces. PULHHEEMS is tri-service, which is to say that it is used by the British Army, the Royal Navy and the Royal Air Force. Its purpose is to determine the suitability of its employees for posting into military zones. It is not a fitness test as such; rather, it is a test of suitability for purpose. The PULHHEEMS system, or variations of it, is also used by several members of the British Commonwealth, including Singapore, Canada, Australia , Sri Lanka and New Zealand. The USA uses a system called PULHES. In civilian life, there is a similar system called PULSES which is used to grade levels of disability; it differs from the PULHHEEMS in that it also examines the digestive system, something which the PULHHEEMS does not. Usage For new recruits it is part of the first step into the armed forces, whilst for established service people it is a requirement of ongoing employment. Although a PULHHEEMS is carried out on new recruits, it is not itself an entrance examination, the attributes of which depend on the unit conducting the examination. The examination is carried out on recruits, and five-yearly after a serviceman or woman reaches the age of 30. After the age of 50, people in service are examined every two years. All Generals of any persuasion must be examined yearly. Furthermore, service personnel under the age of 30 are required to undergo a PULHHEEMS in order to attend certain courses, whether occupational or promotional, and also if medically downgraded. A PULHHEEMS is also carried out prior to leaving the armed forces, in part because many former servicemen remain as reserves. The PULHHEEMS examination can result in medical downgrading if fitness standards do not reach required levels, whether as a consequence of injury, neglect, pregnancy, or old age. Downgrading can reduce a serviceman's pay, and prevent course attendance, which in turn can prevent promotion. Ultimately a serious, permanent medical downgrade can result in discharge from the armed forces on medical grounds. Acronym PULHHEEMS is an abbreviation for the factors it is intended to test. These include: Physique Upper limbs Lower limbs (or 'Locomotion', as this includes the back) Hearing (right) Hearing (left) Eyesight right (corrected / uncorrected) Eyesight left (corrected / uncorrected) Mental function Stability (emotional) Scoring The attributes examined in PULHHEEMS receive a