Introduction A clearly defined core medical curriculum is essential to address content overload and ensure alignment with contextual healthcare needs. The Health Professions Council of South Africa recommended that the University of KwaZulu-Natal define its undergraduate core medical curriculum. This study aimed to achieve stakeholder consensus on the core clinical curriculum by identifying essential knowledge, skills, and attitudes for the senior years of training.Methods A sequential mixed-methods design was employed. Documentary analysis of module templates, course materials, and curriculum mapping data was conducted to identify existing curriculum content, which was categorised according to the African Medical Education Directives for Specialists competencies. Content was verified by module coordinators. An electronic Modified Delphi process involving academics, recent graduates, and primary healthcare nurses was conducted over two rounds to establish consensus, defined as ≥ 70% agreement.Results Documentary analysis identified 724 curriculum items, of which 653 were aligned with the healthcare practitioner role and 71 with other AfriMEDS roles. Seventeen module coordinators verified the curriculum content. Twenty-one participants completed Delphi round 1, and seventeen completed round 2. After the Delphi process, consensus was achieved on 629 healthcare practitioner items and 69 items related to other competencies. A small number of items (n = 27) did not reach consensus for inclusion.Discussion This study defined a stakeholder-informed core clinical undergraduate medical curriculum at UKZN. The findings highlight a strong emphasis on the healthcare practitioner role, reflecting the demands of generalist practice in a resource-constrained health system. The resulting curriculum framework provides a foundation for curriculum renewal aligned with AfriMEDS and supports the training of socially accountable, context-responsive graduates.