Other than oil changes, absolutely nothing has gone wrong.
Great engine, excellent brakes, great cooling system.
Just an all around good 'ol truck.
I'm used to driving high HP vehicles, and this Ram has more than enough power; you just have to know how to use it. It has boat loads of torque out of the box (light the tires and start some fires).
I had an F-150, but it wasn't even good - it was poor actually. I have driven 2008 Fords and Chevy's, and they both rattle, have poor load and tow ratings, not to mention MPG; in my Ram with a bed cover I pull 19-21 on the hwy.
Also a guy on a motorcycle drove into me at 45 mph while I was parked, and all that happened to the truck was a small dent in the bumper.
We owned both an 03 Ram similar to yours with a 4.7 liter and 4x4, and a 04 F-150 4x4 with the 5.4 liter at the same time.
The Ram was a joke. and we traded it in and got an SUV. 11-12mpg average because the engine was so weak you always had to be on it.
Our F-150 got 16-17mpg, and had much more respectable power for pulling our car trailers etc.
I'm sure a hemi Ram would have been the best bet; the base engine is weak in the Ram.