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To the brainlets, which sadly seems to include Kronii, the key difference is that in the trolley problem, all the people are already in danger and set to die by some unseen madman. You cannot intervene in any other way but pulling the lever.
In the surgeon problem, 5 people are already dying, however there is no 1 person on another track tied and set to die. As the surgeon, you are putting that 1 traveler into danger and murdering him. If anything, the comparison is slightly closer to this troll variation of the trolley problem. Which again is a joke, but puts the impetus on you by changing something within the system, you become part of it.