There is no valid training or logistical reason for subjecting residents to extended periods of severe sleep deprivation. From a learning perspective, if you really want people to perform complex tasks super well under potential future conditions of severe sleep deprivation or stress, you train and rehearse them extensively when they’re at their most alert. After they’ve developed extensive practice and so can do these things fairly automatically, it’ll more easily generalize to high-stress, low-sleep situations than if they mostly learned things while only halfway alert from the outset.

As a patient, you bet I’d sue a hospital and the supervisors of any resident who was shown to be sleep deprived when they took out the wrong organ or otherwise messed up my or a loved one’s care. It’s irresponsible, outmoded, and frankly, kind of a narcissistic model of training (the “we are teaching them to be gods like us” model). It should change.