[3] He was an MDS in Endodontics, an MBA from the University of Otago, New Zealand, and an MRACDS (Endo) conferred by the Royal Australian College of Dental Surgeons.

Koshy also worked as Clinical Adviser -Dental to the recently amalgamated new Central Highland Rural Health at Hepburn.

[citation needed] Koshy worked to assist refugees and asylum seekers with oral health care in Victoria.

[12][13] He also worked abroad as a Rotary International dental volunteer with the UNHCR program in Hong Kong for Vietnamese refugees,[14] and Rotary programs with Kikuyu tribes in Kenya, Q'eqchi' Indians in Guatemala,[1] and orphans in Colima, Mexico.

He was the clinical advisor for Smile High Foundation which volunteers in Nepal.He was a former member of the Gippsland Dental Task Force Group, facilitated by Dental Health Services Victoria, which drafted the first Gippsland Oral Health Plan in 2008.