The University of Exeter established a department of general practice on 1 December 1973, just before a postgraduate university department of general practice was established in Denmark. This was the first postgraduate university department of general practice in the UK, modelled on the London postgraduate medical institutes. It was funded by the DHSS to develop vocational training for general practice. For almost a year, Denis Pereira Gray was alone with a half-time appointment as senior lecturer, the only academic general practice presence in the south-west region. Three more part-time senior lecturers, Keith Bolden, Michael Hall and Robert Jones, joined in November 1974, creating the team soon known as the ‘gang of four’.

Exeter became a laboratory for vocational training with radical ideas tested and evaluated. A System of Training for General Practice (1977) became the best-selling of the RCGP's early Occasional Papers and was followed by three books: Training for General Practice, A GP Training Handbook and Running a Course.

Academic features of the Exeter vocational training scheme included an emphasis on three-year training, the use of interactive small-group learning with behavioural de-briefing, rigorous selection of trainers, protected time for trainees in the practices for research, and support for trainees publishing research findings. Between 1974 and 1995, Exeter general practice trainees and one pre-registration doctor had seventeen articles published in the international peer-reviewed literature. Amongst these were an early report of high blood alcohol levels in patients in accident departments, and the statistically based ‘value for money index’ in general practice training.