Mental health challenges are widespread among medical students worldwide, exacerbated by a lack of help-seeking behavior within this population. In resource-constrained healthcare systems like Bangladesh, medical students face additional barriers to expressing their struggles or seeking support. This study is the first in Bangladesh to use the MINI, a confirmatory clinical diagnostic tool, to assess the prevalence of depression among medical students. This cross-sectional study employed a convenient sampling technique, with 529 students from across Bangladesh participating via online surveys. The survey included questions on relevant sociodemographic factors and the PHQ-9 depression screening tool. Subsequently, depression was confirmed through clinical diagnosis using the MINI, conducted via online interviews over Zoom and phone calls. The study was carried out from June 2020 to February 2021, and data analysis was performed using SPSS software (version 22.0). Among the medical students surveyed using PHQ-9, 31.5% exhibited moderate levels of depression, 38.7% showed mild depression, and 29.8% reported minimal depression. Clinical diagnoses conducted using the MINI tool confirmed depression in 50 PHQ-9-positive cases. Of these, 17 (34%) were categorized as having "no depression," 27 (54%) were diagnosed with recent depression, 16 (32%) had a history of past depression, and 15 (30%) experienced recurrent depression. Depression was more prevalent among female medical students, particularly those living away from their families from the start of their degree. First-year students were found to have the strongest association with depression. This study reported that one-third of Bangladeshi medical students experienced moderate to severe depression. The findings underscore the need for targeted psychosocial interventions and further exploration of socio-demographic factors. These results aim to guide researchers and policymakers in addressing the mental health needs of this population through effective support systems and surveillance frameworks.

I have read the journal's policy and the authors of this manuscript have the following competing interests: 1. We have received funding from the Centre for Non-Communicable Diseases and Nutrition (CNCDN) for this research. 2. We declare no other financial and non-financial interests related to this manuscript.

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I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval (IRB Reference no: 2020/OR-NSU/IRB-No.0502) was obtained from North South University, Dhaka, Bangladesh.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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The data underlying the results presented in this study are not publicly available due to ethical and confidentiality concerns related to participants' mental health information. However, data will be made available upon reasonable request to the corresponding author. Requests must comply with ethical guidelines and institutional policies governing access to sensitive data.