Conclusions

Social anxiety was identified in nearly two-fifths of the medical students in this study. Low self-esteem was strongly and independently associated with social anxiety, and lower self-esteem scores were correlated with greater social anxiety severity. Female participants had higher odds of low self-esteem, although gender was not independently associated with social anxiety. These findings identify self-esteem as an important psychological correlate of social anxiety among medical students. Early screening, accessible counselling, and interventions aimed at strengthening self-esteem, resilience, communication confidence, and psychological well-being may help support vulnerable students. Multicentre longitudinal research is required to clarify the temporal relationship between self-esteem and social anxiety and to evaluate the effectiveness of targeted interventions.