1: Story/Characters
--The ending left me underwhelmed, unfulfilled you might say. Bethesda needs their writers to work harder, or get new ones. Period.
--Voice acting: Famous actors are good, but if you are paying them large sums for their names, don't. A big step up from Oblivion, but always room for improvement.
--If you were going for difficult moral choices, you failed. None of the moral choices were tough.
--Go back to the town by town epilogue. The reason this works better IMO, is that the main quest seemed to be the only thing addressed, and it's a fraction of what I really did in the game.
2: Ruleset
--Skill points too plentiful, and some skills are useless. Make TAG skills meaningful. Raise the cap or make it hard to get there.
--Some Attributes useless. Rework derived stat formulas (too much starting carry weight, Ap, HP)... Make EACH attribute useful.
--This also applies to perks. Balance the perks.
3: Humor
--Bring back text descriptions for every item in the pipboy. This opens up a world of humor.
--Silliness also falls into this. Silliness has its place, and is clearly personal taste, but I felt it was approaching overboard.
--Pop culture references are fine, and enjoyable when properly spaced. Not saying there was too much, just this is more the humor I enjoy. Not shooting teddy bears that do more damage than a sniper rifle to the face.
4: Solid Implementation of Game Mechanics
--Radiation management seemed to be an afterthought. Interesting but failed to evolve.
--It should be punishing to have a broken leg. You shouldn't be able to just shoot a stim and be fine.
--Addictions are tough on people. You can't just drop a Benjamin and be cured of your addictions.
--These ideas are merely examples. I don't think I should necessarily have to hobble back to town every time I get a broken leg, but with current implementation I question as to why they are in the game at all. They are little more than annoyances. Fine ideas, just evolve them a little more.
5: Mature Content
--Too much violence, not enough of the rest. I didn't pay that hoker to keep my extra pillow warm until morning. It's not really about the six, its about how they tiptoe around it. This is the WORST implementation of six in a game I have ever seen. I want whole Plot lines related to drugs/addiction, a la jet/myron.
6: Difficulty
--Difficulty selection has so much potential. It shouldn't just dictate combat, but it could change there very ruleset.
--Very Hard was only slightly harder, and only at the beginning. The availability of ammo and stims, and the ability to carry endless amounts let me plow through combat regardless of difficulty,
--Very Hard: Difficult combat, weighted ammo/aids, rarity of ammo/aids, severe radiation, poorly stocked vendors, modified ruleset for skills/attributes. THIS should be hard. You should have to use everything at your disposal to get by. (Just an idea.)
7: Combat
--Vats needs to be balanced. Sometimes overly powerful.
--Melee needs to be able to target body parts.
--Bring back groin shots!
--Each combat skill should have its own style and advantages.
--Death animations sometimes leave me annoyed. Low on my list of priorities, but I think more unique death animations for each weapon would refresh things.
--Find niches for weapons, and don't obsolete them so fast. Sniper rifle should WORK in Vats at long range, but be more limited up close.
--A little better weapon progression.
8: Factions/Quests/Jobs
--Where are the factions? You put a lot of work into developing some cool concepts. Talon Co., Outcasts, but I can't join them.
--At least some factions need to be opposing. Factions should have unique quests and rewards. Not JUST quests, but quest CHAINS.
--Why can't I go on slave runs with a group? Why can't I be a caravan guard? Why can't I be a raider?
9: Map/Exploration
--Good size map, but need a few densely populated cities/towns with more characters and quests. Some interesting things can open up with this, as well as a bigger way to impact the world.
--Too many 3 citizen, 1 quest locations.
--I was sure you were going to let us get a vehicle. A trunk (or saddlebags for a motorcycle) is always a great place to stash your extra gear. (Low priority)
10: Workbench/Crafting
--I think maybe some of your thoughtful creations blinded you to the potential of the workbench.
--Find schematics and parts and modify your favorite weapons. Add silencers, expanded magazines, high compression barrels, extended barrels, Low recoil grips, scopes.
--Allow for Ammo Re-caliber using the workbench. 2 to 1 ammo exchange rate. (Just an idea.)
--Use science skill to create drugs using the laboratory with chemicals you find. (Just an idea.)
EDIT: For clarity, and removed mass effect reference.