There is a significant shortage of qualified psychiatrists and related service providers in Pakistan against the backdrop of burgeoning evidence of a high prevalence of mental health disorders in the country. At the Aga Khan University Medical College, psychiatry has been taught to the undergraduates as a mandatory one-month clinical rotation since 1987. AKU is the only medical college with a formal psychiatry training at the undergraduate level. In 2017, a team of faculty members reassessed the curriculum, teaching methodology and learning outcomes of the psychiatry rotation. As a result, an outcome-based, blended curriculum was designed to integrate virtual and classroom-based learning with patient-skills training. The new curriculum has now been in implementation for one year. The article aims to discuss and reflect on the process of reviewing, redesigning, and piloting a psychiatry competency-based curriculum (CBC) which used the ‘Six-Step Approach’ proposed by David Kern. This paper highlights the challenges of curriculum design and its implications in the broader context of Pakistan. The insights add to the existing literature about the experience, challenges and successful outcomes of designing a blended curriculum in Pakistan. The authors’ critical reflections also inform future directions regarding the design and implementation of a Pakistan-wide mental health programs.