Background: Depression is the single largest contributor to global disability and disease burden. Medical students are considered a vulnerable group because they have to deal with stressors specific to medical education. Psychological morbidity in medical students represents a neglected public health problem and holds major implications for health services and mental health policymaking.

Aim: To ascertain the prevalence of depression and its impact on academic performance among medical students.

Design: A systematic review

Data sources: Systematic search for worldwide published literature from PubMed, PsycINFO, EMBASE, Google Scholar, EMBASE, Science Direct, BioMed Central and Medline databases

Study eligibility criteria: Studies included in this review reported the methods and/or measures for the prevalence of depression and academic performance among medical students

Data extraction: Data extraction was undertaken by the first reviewer, and checked by a second reviewer. All identified papers were critically appraised independently by both reviewers. Information was extracted from each included study (including author, title, year and setting of study). These data abstraction forms were reviewed and eligible papers entered into the meta-analysis.

Result: Out of a total of 2,236 publications retrieved, after examining the titles, abstracts (if abstract was unavailable, the article was nevertheless counted) and the reference lists for related articles, only 14 studies satisfied all the inclusion criteria. Non-English articles (French 1, Japanese 1, Mexican 1, Korean 2) were excluded to save time and cost.

Conclusion: Moderate and severe depression showed a high prevalence among medical students. The presence mental health services for university students and medical students in particular is important. Efforts of professors in charge of preparing the exams should be directed towards making the oral and clinical exams more transparent.