Two problems related to engine cooling system have been reported for the 2003 Ford F-350. The most recently reported issues are listed below.
I smelled hint of raw fuel when the engine was warm for 1-2 months prior to the obvious problem. 3-4 weeks prior to professional inspection there was white smoke out of the exhaust for 1-2 minutes. This smoke was associated with rough idling that when away completely until the next cold start up. The precipitating event for professional inspection was raw fuel spraying onto the trailer that was being pulled. Inspection revealed raw fuel pooled on the horizontal engine surfaces and raw fuel in the cooling system. This was verified by manufacturer's dealer service department and found to be a leaking fuel injector cup. It will require changing all the fuel injector cups. The dealer service agent reported that this same problem has been several times in these particular models. It is usually a warranty item. This has not been repaired yet as this vehicle's warranty has expired by time limit but not mileage. The manufacturer has denied any obligation to help restore the vehicle to safe operation given that it seems to run unimpaired from a performance standpoint.
My 2003 F-350 super duty 5. 4, with 3,500 miles has an engine knock on cold start-up. The dealer had the truck for a week, and said this is normal. I took an oil sample, and had it tested, and was told the sample had to come from a high mileage motor,the sample shows traces of bearing material. The dealer says this is normal for "break-in" oil. I think there is more wrong, and don't want to ruin it. This is a $30,000 truck, and I can't see tearing it up.