I started the game last night. Having never played either of the previous Fallouts or Oblivion, I came at it with no expectations. I played through the first major plot point (growin' up in a vault!) and a while I like it a lot so far, there are some big stumbling points.
1) Gunplay almost breaks the game. I've never experience such awful FPS targeting. I understand that you're supposed to use the VAAS system (whatever it's called), but you don't even get a tutorial on that during your time in the vault. But unless you're at point-blank range, guns are horrible.
2) There's very little direction once you get out into the Wasteland. I must've wandered aimlessly for twenty minutes before I tripped over the first major city in the game. The game could really benefit from a GTA-type radar, showing you where to go next.
3) Getting shot does a LOT of damage, and you have virtually no recourse but to spend money at a clinic to get healed. I haven't come across one...stinking...med pack yet.
The game is, however, hauntingly beautiful. I'm actually going to restart tonight now that I (sort of) know what I'm doing. Maybe I won't go into the Wasteland with NO freaking health this time.