A buddy of mine has a venison ham roast that he wants me to cook. How would you guys do it? Love to hear some opinions.

Go.
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When in doubt, smoke it.
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You could actually treat it like ham and brine it for a bit to cure, then, as Travis said, smoke it.
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Get some real maple syrup, not the Aunt Jemima stuff.

Dry the ham. Generously cover the ham with syrup and sprinkle very, by generously with cinnamon. Put in the fridge overnight. Dice a couple sour apples into 1/8" cubes. When ready to cook, do so either on the grill in a pan (best choice), but the oven works well set at 300 degrees. Now make sure the syrup and cinnamon mixture is thick, if not add more syrup - or even start a new mixture, now adding the diced apples and cook. Treat as beef in regard to cooking. Personally, we like it rare. A meat thermometer is a great tool at this time to get the center to the proper temp.

Serve thinly sliced with the juices and apple chunks liberally drizzled over the sliced venison.

I also like to adde cursed black walnuts or pecans to the apples and I the cooking. Each adds their own unique flavor.

TOO MANY PEOPLE OVERCOOK VENISON THINKING IT NEEDS TO BE COOKED COMPLETELY AND THEN COMPLAIN It IS TOUGH.

Peace of The Lord be with you.
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I didn't even know there was such a thing as Venison Ham...

I learn all kinds of new things from you guys... Guess I need to buy my friend a box of 30-06 and tell him to get to work... :-)
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What should I get the internal temp up to? Overcooking and lack of fat are my biggest concerns with it.
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135-145 is good for most red meats. Also, if you're worried about it drying out, you can inject it with some melted garlic butter.
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You can always drape slices of bacon over it to add some fat.
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