My association with medical education goes back to 1993, when I started attending workshops on educational planning, assessment and evaluation. In 1995, my employers sent me to the University of Maastricht to learn how the system of problem-based learning (PBL) worked, so that I could ‘transfer the technology’ back home. By 1996, I and colleagues had developed Pakistan’s first integrated medical curriculum with PBL as a major instructional method. Since the mid-nineties, thus, I have been watching institutions and institutional heads follow internationally (read ‘western’) acclaimed trends without thinking of the impact of these ‘innovative’ methods in our context. This has prompted me to write about academic fashions or trends that seem to have gripped Pakistan for more than three decades. We are not only eager to adopt western methods; we race to take the lead in doing so! Hence, the title of this chapter. I have attempted to trace the history of how medical education evolved in Pakistan with the sole purpose of linking its evolution with its impact on undergraduate medical education policies and practices. The primary purpose of writing this is to share my reflections, my perspective, about how and why things transpired to be the way they are and what may be done to improve the situation.