ship or shore establishment sick bay. Continuation of training Throughout their career an MA must complete a rolling OPS task book, which was introduced in to the MA branch in 2010. This task book covers all skills required for the MA to maintain their clinical skills in the primary care, secondary care and emergency care environments as well as medical administration and various maritime components. The various sections vary from being required to be completed annually to three yearly. The task book must be kept up to date and is an annual requirement if the rating is to be expected to even meet the basic qualifying criteria for further promotion. This ensures the MA remains current and motivated with their knowledge and skills. The rolling OPS task book is currently only required for the MA and Leading Medical Assistant (LMA) rates. Pre-front line assignment training Prior to joining a ship, submarine or 3 Commando Brigade, MAs must conduct either the Maritime or Commando MA's Pre-Joining training of 6 weeks duration. This is conducted at the Institute of Naval Medicine and involves refresher and update training in primary and emergency care, medical administration and dental first-aid. The Maritime component involves exercising on board . Those completing the commando component practice field exercises in the Role 1 and 2 field medical environments at Commando Logistic Regiment Medical Squadron. Included in the pre-joining training is the Battle Field Advanced Trauma Life Support course. Commando Medical Assistant Royal Navy Medical Assistants who volunteer for service with the Royal Marines must pass the All Arms Commando Course (9-weeks) held at the Commando Training Centre Royal Marines (CTCRM) in Lympstone, Devon. Prior to this the Pre-All Arms Commando Course (4 weeks, Commando Logistic Regiment) must be taken to ensure candidates are suitable, selected and prepared prior to the All Arms Commando Course. The MA branch is also open to Royal Marines who are designated as Royal Marines Medical Assistants (RMMA). Those that go on to work with reconnaissance sections of 3 Commando Brigade complete the basic military parachutist course. Medical Assistants working in support of United Kingdom Special Forces Those (Commando trained or Royal Marine Commando only) who have completed at least two operational tours and have passed the arduous Black Serpent course can be selected to provide medical support to UK Special Forces (UKSF) for either the Special Air Service (SAS), Special Reconnaissance Regiment (SRR),