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 hms bristol. 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), special forces support group (sfsg) or the special boat service (sbs). they then go on to complete the basic military parachutist course and, if required the haho and halo para courses. black serpent selection and training the black serpent course is tri-service and open to rn, raf and army personnel. it is run by the medical support unit (msu), hereford and features various physical and other tests including a hills phase with march routes across the brecon beacons similar to those done for uksf selection. candidates will be expected to carry out simulated medical treatments during these marches. the goal of such exercises is to test a medic's ability to successfully perform while under pressure and exhausted. submariner medical assistant those who volunteer for service in the submarine service are responsible for the monitoring of air and water supplies and carrying out vital health and environmental safety checks. the training is undertaken at hms sultan in gosport and at the institute of naval medicine in alverstoke. on completion of this training, medical assistant submariners, ma(sm)'s are awarded a city and guilds certificate in radiation protection and optional membership of the guild of radiation workers. additional qualifications other additional specialisations open to the ma cadre are, pharmacy technician and operating department practitioner, which are civilian accredited and have become medical technician branches once again. insignia/badge the insignia of the medical assistant badge is the red cross of geneva on a white background with gold circling. a royal crown above the insignia denotes that the rating is qualified at the senior rate level (po). rating structure the branch structure of the medical assistant follows the same as structures of the other branches of the royal navy. medical assistant 2 (under training) (ma 2) medical assistant (ma) leading medical assistant (lma) petty officer medical assistant (poma) chief petty officer medical assistant (cpoma) warrant officer medical assistant class 2 (wo2ma) warrant officer medical assistant class 1 (wo1ma) medical services officer those who are at po level who are qualified, recommended and selected, can go on to become medical services officers (mso). they undertake their initial training at britannia royal naval college (brnc) dartmouth. the mso are commissioned officers who provide policy, guidance and other managerial, administrative and staff skills to the medical branches of the royal navy and tri-service environment. the highest level they can reach is that of captain, although there has been one instance of a commodore. the msos were also previously called ward masters.