Nobody talks about fitness the way Dr. Shernan Holtan does. Maybe because her background makes her an unlikely person to be giving lifting advice in the first place. She’s an oncologist and hematologist at Roswell Park Comprehensive Cancer Center in Buffalo, spending her days treating blood cancers and managing bone marrow transplants. She also holds a national powerlifting record. The two facts sit together oddly until you hear how she got there.
In 2013 she was genuinely burnt out. Brutal hospital hours, two young children, essentially no time left over for herself. She joined a gym with no particular ambition beyond getting a break from her schedule. A coach got her into powerlifting and it turned into something she never expected. Six years later she held a national squat record. Her full story is on the Hastings College profile if you want the longer version.
What she took from that experience ended up shaping how she treats patients. She now runs a program called Frail to Fit at Roswell Park, built around helping cancer patients recover physical strength during and after treatment. Exercise, in her view, belongs in the same category as medication. Not a bonus. Not optional.
Who Are These Tips Actually For
Not competitive athletes. Not people with four free hours a day. Her approach was built around someone who has a real job, a real life, limited time and no particular background in sport. If you’ve been putting off getting started because the gap between where you are and where you want to be seems too large, that’s specifically the audience she’s thinking about.
1. Weights Before Cardio, Especially at the Start
Most people default to cardio when they first decide to get fit. The treadmill feels manageable. The weights area can be intimidating. Holtan would tell you to flip that.
Resistance training produces changes that cardio simply doesn’t. Muscle mass goes up. Bone density holds steady or improves. Your resting metabolism gets a lift. Joints get stronger over time rather than worn down. Once you’re past 30, muscle loss becomes a genuine background process unless something is actively countering it. Cardio doesn’t counter it. Lifting does.
You don’t need much to get going either. Bodyweight squats, push-ups, a resistance band or a pair of dumbbells. The movements that matter most, squats, deadlifts, rows and presses, can all be learned at low intensity before you ever step near a barbell.
2. Progress Has to Be Built In, Not Hoped For
The principle Holtan credits most for her own development is progressive overload. It’s not complicated. You make each session slightly harder than the last, whether that’s a bit more weight, one or two extra reps, or a shorter rest between sets.
Without it, the body adapts and stops responding. You can train for months and go nowhere if the workouts never change. Adding two or three kilograms to a lift each week seems almost trivial in the moment. Across a full year it becomes something genuinely significant.
Keep records. A cheap notebook works just as well as any app. The point is being able to look back and confirm you’re actually progressing rather than just repeating the same session on a loop. Research in this area consistently links progressive strength training to improvements in cognitive function and mental resilience too, not just physical results.
3. Sleep Does More Work Than the Gym Does
Holtan has mentioned in interviews that her sleep improved noticeably within the first few weeks of training seriously. People often find this surprising. They think of exercise and sleep as separate things. They’re not, really.
The repair work happens overnight. When you lift, you create small tears in muscle fibers. During deep sleep the body patches those tears and in doing so builds the muscle back slightly stronger. Growth hormone gets released during this process. Interrupt the sleep and you interrupt the adaptation. Physically, seven to nine hours is the range where proper recovery tends to happen for most adults.
Rest days follow the same logic. They’re not wasted days. Light movement, walking, stretching, something gentle, keeps blood flowing to muscles without adding stress. The mistake most beginners make is treating rest as laziness rather than as a deliberate part of the training.
4. Two Exercises She Rates Above Everything Else
In a Business Insider interview Dr. Holtan named squats and deadlifts as her two most valued movements. Both of them train a large portion of your body at once, which is why she keeps coming back to them. Legs, glutes, core, back, all of it gets recruited whether you’re squatting or deadlifting.
Squats develop lower body strength and, when performed with decent technique, build real stability around the knees. Deadlifts work what people call the posterior chain, essentially all the muscles down the back of your body, and that chain is what keeps your spine supported and your posture from collapsing. Training both of these a few times per week, without going particularly heavy to start, tends to show results within about six weeks.
The thing Holtan emphasizes and that most beginners skip past is mastering the movement before loading it. A technically sound squat with light weight is doing more useful work than a heavy squat with sloppy form, and it’s also far less likely to land you with a knee or lower back problem.
5. A Schedule You’ll Actually Follow Beats a Perfect One You Won’t
She’s not a fan of extreme weekly schedules and she doesn’t recommend training every day. What she advocates for is a structure small enough to be genuinely sustainable, one that fits into your existing life rather than requiring you to rebuild your life around it.
For a beginner, something like this is enough to make real progress: three strength sessions per week, each running 30 to 45 minutes. One or two lighter days with walking or stretching thrown in. Two full rest days. That’s a full week and it leaves plenty of room for everything else.
The person who does that for a full year without missing many sessions will be in a completely different physical place than someone who trained intensely for a month, burned out, and stopped. That gap compounds over time and it’s enormous by the end.
6. The Mental Shift That Changes Everything
Holtan talks about exercise as medicine and she means it literally, not as a motivational phrase. She’s not interested in framing movement as punishment for eating, or as something you have to suffer through to earn a rest day. That framing makes people quit.
When you treat exercise as something you do because it protects your health, improves your sleep, sharpens your thinking and extends the period of your life when your body actually works well, showing up becomes easier to justify. Especially during weeks when motivation has evaporated.
Her Frail to Fit program at Roswell Park is the most direct evidence she has for this position. Patients going through chemotherapy, dealing with exhaustion, nausea and physical weakness, still benefit measurably from structured physical activity. If movement can do something meaningful for people in that situation, the case for healthy adults making time for it is fairly hard to argue against.
To Sum It Up
Dr. Holtan started lifting at a point in her life when she was overextended and tired, looking for nothing more than a bit of time to herself. What she found was a process that works precisely because it doesn’t ask for perfection or heroic effort. Compound movements done consistently, with progressive challenge built in, proper sleep taken seriously and a sustainable pace maintained. None of it is glamorous. All of it works.
If you’re starting from zero or coming back after a long gap, the approach she describes is a reasonable place to begin. Small steps taken regularly tend to outperform large steps taken briefly. That’s really the whole argument.
