Dr Koech is a nephrologist i.e. a kidney disease specialist. He did his nephrology training at Tygerberg Hospital and Stellenbosch University in Cape Town (2016). Prior to that he had completed his internal medicine training at Moi University (2013) and undergraduate medical training at the University of Nairobi (2006).

He teaches nephrology at the Moi University School of Medicine and participates in the care of patients with kidney diseases at the Moi Teaching and Referral Hospital. He also offers service from his private practice at Oak Tree Centre and St Luke's Hospital both in Eldoret. His main interest is in kidney transplantation and chronic kidney disease.