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.