So I recently decided to give Ultima 7 a play.

What is the best way to go about it?

Native DOS? and if so what are some needed fan patches (if any) that I absolutely NEED to install?

U7 nitpickers? is there an equivalent patch for Serpent's isle?

or

Exult?

can I just install Exult and start playing? Does it come with bug fixes baked in?

any needed patches/mods/bugfixes for Exult?

Any information would be appreciated.

are there any comprehensive fan patches?

I'd say Exult. The higher resolution and tweaks (like walking animation speed IIRC) are a godsend.

I'm also a big fan of Exult, mainly for the larger resolutions and hit point bars. But purists might prefer DOSBox.
If you're going for Exult, just grab the latest snapshot from their website, as well as the All-In-One Audio Data pack installer on the same page.