It's possible it could be either the cam or timing like the others have said. If changing the timing doesn't work, pull the valve covers & watch the rockers to see if any are loose/clattering around. If all seems well there, next step would be to check the timing chain. If the engine has never been apart it may have quite a bit of slack in it.
Here's what the chain in a 350 from an '88 pickup I used to have did:
http://www.youtube.com/watch?v=BAqKc89-Sis
Here's what the chain in a 350 from an '88 pickup I used to have did:
http://www.youtube.com/watch?v=BAqKc89-Sis