General neurology is at an inflection point as subspecialization rises and academic roles tilt toward heavier clinical loads. In this conversation, Drs. Amy Pruitt (Penn) and Steven Lewis (Lehigh Valley/Jefferson) unpack why generalists remain indispensable for undifferentiated cases, resident education, and departmental balance—and outline practical steps to strengthen training, protected time, and career pathways. Listeners will hear candid perspectives and hopeful signals that with intentional support, general neurology can thrive in academic centers.